Digital Health & AI Rising Star Award Nomination Form

Nominee Information

Nominee Name:

Nominee Email:

Nominee Age (as of December 31, 2024):

Nominee Title/Position:

Nominee Affiliation:

Your Name:

Your Title/Position:

Your Email:

Your Relationship to Nominee:

Nomination Statement (500 words maximum):

Others (LinkedIn, Website, Publications, Media etc):

Upload Supporting Documents (PDF, max 5MB):

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