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PMC Stroke Champion Online Nomination Form

Honor members of the PMC Staff that serve as a champion for patients and stroke survivors. Any PMC Employee is welcome to nominate a coworker deserving of this designation. Fill out the Online nomination form below.

 

My Name:

First Name:

 

Last Name:

 

Department:

 

I would like to nominate:

First Name:

 

Last Name:

 

Department/Unit where the nominee works:

 

Job Title:

 

Please describe why this employee should be considered a PMC Stroke Champion! Tell your story and try to write your story in detail! This is how our committee picks the winner!

Pikeville Medical Center