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.