NOMINATION FORM Nominations are due by the 15th of the month before they will be awarded.
E celance
• For example, nominations for the Rising Star Award for January are due by December 15th. • Nominations will be reviewed monthly by the Nursing Excellence Team. • Winners will be recognized in the monthly “Excellence in Action Newsletter” in collaboration with the Nursing Recognition and Retention Committee.
Click on each award for a description and nomination criteria, then check the box for selection. c Positive Energy Award (all Excela Health) - JAN
c Collaborative Care Award - AUG
c Rising Star Award - JAN
c Patient-Centered Care Award
c Nightingale Bedside Award - FEB
(all Excela Health) - AUG
c C.A.R.E. Award - FEB
c Innovations in Nursing Practice Award - SEP
c Advocacy Award - FEB
c Team Building Award - OCT
c Strategic Influence Award - MAR
c Mentorship Award - OCT
c Above and Beyond Award
c Outstanding Preceptor Award - OCT c Quest for Quality Award - NOV
(all Excela Health) - APR c Community Service Award - APR
c Improved Outcomes Award - NOV
c Safety in Nursing Award - JUN
c Health Care Hero Award
c Clinical Excellence Award - JUL
(all Excela Health) - DEC
c Dynamic Leader Award - JUL Name of Nominee: __________________________________________________________________ Job Title/Department: ________________________________ / ______________________________ Location: c WH
c LH
c FH
c ESN
c ESL
c EHMG
c Home Care & Hospice
c Other
Nominator Name: ___________________________________________________________________ Job Title/Department: ________________________________ / ______________________________ Nominator Contact Information: _______________________________________________________ Please use the space provided on the next page to describe your reason for this nomination and include specific examples.