Download and fill out the nomination form, then email it to info@patientplusuc.com OR fill out the nomination form below!

Nomination Form

Prize List

The Excellence Award is for the team member who displays the ultimate passion for quality patient care. This person is a leader who is consistently attentive, respectful, efficient, and works well with any team. They exemplify our commitment to 1% continual improvement daily and embody our motto of “Every Patient, Every Time”.

Nominee

Please enter the first and last name of the team member you believe is a deserving recipient of the Excellence Award.

First Name

Last Name

Reason for Nomination

Provide SPECIFIC examples of how this team member clearly demonstrates the qualities of an Excellence Award nominee.

Nominator

Please include your full name so that we may include you in the celebration should the team member you nominated be selected to receive the Excellence Award.

First Name

Last Name