| Your Name: |
|
| Phone: |
|
| Email: |
|
| I am a: | Patient
Visitor/Family
Volunteer
Employee
Physician
|
| Work Location: | |
| Date: |
|
I nominate from unit as a deserving recipient of the Golden Stethoscope Award.
|
The following scenario is an example of his/her exceptional patient care, highlighting the wonderful work done by providers every day (please provide a specific situation):
|
characters left
|
|
