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DAISY Award® Online Nomination Form

Honor the compassion and care nurses provide their patients every day with the DAISY Award! Patients, visitors, nurses, physicians, and employees are welcome to nominate a deserving PMC nurse for the DAISY Award. Fill out the Online nomination form below.

My Name:
First Name: Last Name:

Email:

Phone Number:

I am a:
Patient
Visitor
Family member of a patient
Nurse
Physician
Hospital Visitor
PMC Employee
Other

I would like to nominate:
First Name: Last Name:

Department/Unit where the nominee works:

This nurse exhibits the following qualities and attributes (please check all that apply):
Makes a special connection with the patient and family
Includes patients and families in the planning of their care
Does an excellent job educating patients and their families
Works well with the healthcare team to meet patient and family needs
Makes patients and their families feel comfortable
Goes above and beyond

Please describe a situation involving the nurse you are nominating that clearly demonstrates he/she meets the above criteria for The DAISY Award. Tell your story and try to write your story in detail! This is how our DAISY Committee picks the winner!