Imaging Professional for Excellence 2024 Nomination | North Carolina Society of Radiologic Technologists

Imaging Professional for Excellence Nomination

Nominators Name

Nominators Email

Nominators Phone #

Nominee Name

Nominees Email

Nominees Phone #

Nominees Job Title and Employer

Nominees Credentials

What is the highest level of school they have completed or the highest degree they have received?

How many years of experience does the nominee have as a registered medical imaging or radiation therapy professional?

Please select from the choices below any professional involvement the nominee has engaged in.

Professional Society Memberships

Served on a committee within NCSRT or other Medical Imaging Society or comparable

Held an office for NCSRT or other Medical Imaging Society or comparable

Other

Please describe how the nominee positively promotes and advances the Medical Imaging and Radiation Therapy profession in their practice setting and/or in the community.

Please describe the nominee's character and how they demonstrate integrity, honesty, and function within their scope of practice.

How does the nominee display commitment to patients, families and their colleagues?

Describe how the nominee interacts with others to assist in their professional growth.

Do you consider your nominee to radiate energy and truly make a difference to overall outcomes in your practice setting? If yes, please explain "why".

In one sentence - please describe what makes this person an outstanding Imaging Professional.