Advocacy Award







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McDowell Pain Advocacy Award

The McDowell Chronic Pain Advocacy Award

Nominations for The McDowell Chronic Pain Advocacy Award are being accepted now to September 15, 2010 @ 5pm.
Please fill in form below and submit online or print and mail your nomination.

The McDowell Chronic Pain Advocacy Award is given to an individual who has demonstrated outstanding commitment to assisting and advocating for people with Neuropathy pain and who has made a significant contribution within the field of research, education or patient assistance. Melanie McDowell was a longtime advocate of early detection and proper treatment access for patients of Neuropathy conditions such as (RSD) Reflex Sympathetic Dystrophy. Her motivation to finding a cure for RSD, activism, strength and wisdom is greatly missed. Melanie’s efforts prior to passing in July, 2006 are being honored by her surviving family members and is the driving spirit behind this award.

The next McDowell Pain Advocacy Award will be presented at Comic Pain Relief 2010. Winning Recipient of this award receives $200 grant, plaque presentation, and tickets to Comic Pain Relief 2010.

This award is presented to an individual who has demonstrated outstanding commitment to assisting and advocating for people with Neuropathy pain.

Please submit the requested information PLUS any additional information outlining the Nominee's contributions such as their resume/short biographical. We may request additional information after receipt of your nomination.

Past Winners

NOMINATIONS FORM FOR 2010 AWARD
Name of Nominator (Person Filling Out this Form)
Address
City, State, Zip
Phone (format:(ddd) ddd-dddd)
e-mail
Name of Nominee (Person you are Nominating)
Address
City, State, Zip
Phone (format:(ddd) ddd-dddd)
e-mail
What qualities does the nominee possess that makes you feel they deserve the award? (500 max characters)
What significant contribution within the field of research, education or patient assistance has the nominee performed? (500 max characters)
How long has the nominee been involved with your organization or practice? (250 max characters)
Please list any other information you have in regard to the nominee, you feel will assist us in our selection. (500 max characters)
Please e-mail any additional materials or mail them with printed application form.
By your checking accept and clicking submit you attest that all information above is true and correct to your knowledge.
Signature if printing fax/ mail submission
Today’s Date (format: mm/dd/yyyy)
If submitting online please check the box to the right- Signed Electronically by submission:

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