Helping Hands Recognition Form UI Hospitals and Clinics award for support staff involved in direct patient care I would like to nominate ___________________________________________________ who works on __________________________ (unit/area) for the Helping Hands Award. My nominee is a true team member, a positive role model and an individual who exhibits excellent communication skills, is a professional who is consistently caring and compassionate. He/she makes a difference in the lives of patients and/or patients’ families as indicated in the following detailed description:
___________________________ My name (print)
_______________ Phone
________________________ Email
I am a (please check one): RN _____
MD _______
Family Member ______
Visitor ______
Patient ______
Volunteer ______ Other (please specify): _____________________________ Please send this completed nomination form to: T125 GH Nursing Recruitment Office and/or place in provided yellow envelope and place in campus mail.
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Signature: ______. Proposed by: Course: ID Card Number: ______. Signature: ______ ... Please also send a digital photo of yourself and prepare a 2-minute.
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