Remodel/Renovation Competition Form

Please complete all fields to submit your reservation for the Healthcare Design Remodel/Renovation competition. The Submission Coordinator will receive a template with instructions for preparing presentation materials. Entry fees will be invoiced when the issue mails and are non-refundable.

Project Information

Name of Facility*

Your project may be any single space within a larger healthcare facility/campus or a standalone facility dedicated to one specialty or service line.

Spaces that qualify: Patient unit, clinic, department, specialty care center, lobby/entry space, dining or other public area, etc.

Spaces that do not qualify: Entire hospitals or buildings housing multiple clinics or departments. (In that case, one portion of the renovation must be chosen and submitted.)

Please provide a brief description of this single space (up to 10 words):

Description of Space*

NOTE: Projects must be completed after May 30, 2020.

Is This Project:*

Complete
Project in progress

Company Contact Information

Submitting Firm Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Who Will Be Coordinating This Project Submission?

Submission Coordinator*

First Last

Coordinator Email*

Coordinator Phone*

Submission Authorization

I understand that our company will be invoiced $733 and that I may not cancel once my submission is received and accepted.

Your Name*

Date*

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