Please nominate a deserving recipient of The Daisy Award.  This nurse is a role model for GBMC's mission, "To every patient, every time, we will provide the care that we would want for our own loved ones."
Listed below are examples of how nurses qualify for this award:

• Made a special connection with me and my family

• Went above and beyond to meet my expectations

• Significantly affected your clinical outcomes

• Included me and my family in my ongoing plan of care

• Included me and my family in education and discharge preparations, answering all of my questions in a way I/we could understand

• Included other healthcare team members if he/she could not answer my questions or resolve any issues


* Indicates required information
Name of Nominee * 
Unit/Department of Nominee * 
Please share the story (or stories) that clearly describe how this nurse exemplifies our mission: * 
Thank you for taking the time to nominate an extraordinary nurse for this award. Please tell us about yourself, so that we may include you in the celebration of this award should the nurse you nominated be chosen  
Your Name 
Phone Number 
Email 
Unit/Room Number While in Hospital 
I am (please select one) 
Date of Nomination  Calendar (mm/dd/yyyy)
Authentication * 

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