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Celebration for Compassion and Care Nomination Form

  • If you work for a long-term care facility or healthcare organization and you are nominating an employee or co-worker, please include the name.
  • If you work for a long-term care facility or healthcare organization and you are nominating an employee or co-worker, please include your job title.
  • Examples: Supervisor, Co-worker, Client, Resident, Resident's Family Member, etc.
  • Please provide your phone number should we require any follow-up information.
  • Please provide your email so we can keep you up-to-date on the status of your nomination.
  • For the description of each award, please visit the event webpage.
  • This will be used to notify them if they make it as a Top 10 Finalist and will be invited to the event.
  • Please provide any credentials the nominee may have. (i.e. LPN, RN)
  • Please provide the name of the facility or organization in which the nominee is employed.
  • *PLEASE NOTE: If your nominee is chosen as one of the 10 finalists, you will be asked to submit a video further detailing why your nominee deserves to win. Instructions to follow.