Public Dental Clinic of the Year nomination form

Public Dental Clinic of the YearNomination form

Public Dental Clinic of the Year nomination form

Nominee details Your details (if applicable)

Name Click here to enter text. Name Click here to enter text.

Organisation Click here to enter text. Address Click here to enter text.

Phone Click here to enter text. Phone Click here to enter text.

Email Click here to enter text. Email Click here to enter text.

In 500 words or less, please outline how your team/clinic has shown excellence in public dentistry.

The judging panel will take into account the following considerations in reaching their decision:

How the team or clinic helped to improve service delivery at the clinic or in the wider public dental sector

How the team or clinic encouraged a population health approach encouraging external partnerships to promote community health

How the team or clinic showed organisational excellence to improve productivity and patient satisfaction outcomes.

Terms and conditions of the awards can be found on www.dhsv.org.au/awards.Click here to enter text.

Please remember to attach any supporting documentation to your nomination upon submission.

Send your completed nomination to awards@dhsv.org.au or submit an online nomination. Nominations close on September 25.

Winners will be announced at the 2015 DHSV AGM on November 26.