Nomination form

To have your nomination considered please ensure that you fully complete this form. We recommend you review the questions asked below first and then draft your answers in a word document which you can then copy and paste into the text boxes.

Contact details for nomination
First Name
Last Name
Name of Clinic/Organisation/Institution/Company (if relevant)
Phone number
Email address
Are they an iO member? (if known)
About the collaboration
1. Provide a brief summary of the collaborative activity that has been applied
Your answer (maximum 500 words)
2. Provide more details about the activity
To help you with your answers we have provided some questions. You only need to answer those which are relevant to the nominated activity. Answering multiple questions does not in itself lead to a stronger application. The activity will be measured on its individual merits for collaboration in a specific area.
a) Does this activity provide ways for providing a professional support and wellbeing network for osteopaths? If yes, please tell us more. (500 words maximum)
a) Continued (500 words maximum)
b) Does this collaboration use new, innovative ways to build professional networks across the profession? If yes, please tell us more.
b) Continued (500 words maximum)
c) Does the collaboration provide a forum to share best practices in one or more of business skills, clinical skills or evidence-informed osteopathic practice? If yes, please tell us more.
c) Continued (500 words maximum)
d) Does the activity support collaboration with local community groups, businesses or other healthcare practitioners to improve patient care and/or accessibility to osteopathy? If yes, please tell us more.
d) Continued (500 words maximum)
e) Does the collaboration increase professional recognition, public awareness and/or the role of osteopathic care in improving health? If yes, please tell us more.
e) Continued (500 words maximum)
3. Are there any other aspects and/or outcomes that you wish to share with the judges that demonstrate the value of this collaboration?
Your answer (maximum 500 words)
Your contact details
If you are self-nominating please skip this section.
First Name
Last Name
Email address
Phone number
Are you an iO member?

If you have any questions or experience any difficulties with the form please contact the Communications team via email at

How this data will be used:

  1. The information provided will be for exclusive use by the Institute of Osteopathy (iO).
  2. Any information provided may be used by the iO in its print and online publicity materials for this award.
  3. The iO will not share the data submitted with any third parties.
  4. The iO will hold this data securely.
  5. For more details of the iO's privacy policy click here.