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STEP 2. Download our Official Entry Form. Complete the form. Do not exceed the word count specified in each field. When you have completed the Word Document, return to this page and proceed to Step 3.

STEP 3. Fill in all of the fields below. Then use the "browse" button to include your entry form.

* Organization Category:

* Name of Healthcare Organization:

* Address:

* City/Province

* State: (required for US only)

* Country:

* Zip Code:

* Web site address:

* Primary Telephone Number:

* Name of chief executive:

* Name of person submitting entry:

* Organization:

* Position:

* Address:

* City/Province:

* State: (required for US only)

* Country:

* Zip Code:

* E-mail address:

* Phone Number:

Fax Number:

Browse to your completed Official Entry Form here:

* Word Document:

After submitting, you should receive an e-mail confirmation of your entry within a few days.