Request Content Submission New York / NYSARH / Request Content Submission If you are a NYSARH Member looking to add content or opportunities, fill out this brief form so that we can best organize and design your content in the most effective way. 1Nominee Information 2Brief Summary 3Your Information Nomination Category This nomination is for the following category: (Please select one) Senator McGee Award Dr. Gary Ogden Rural Health Practitioner of the Year Outstanding Rural Health Program Nominee Information Nominee Name: Phone Organization (If employed): If nominee is an organization, list contact person and title Contact Person: Title: Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Rural area affected by project: If nominating a collaboration, please name all partners and their roles: References Names and contact information for three references Name: Phone Email Name: Phone Email Name: Phone Email Brief Summary Please provide a brief summary (500 words or less) of why you believe this individual, organization or program should be nominated. Your details Name: Phone Email