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Celebration of Achievement - The Patient Award

Please use the form below to nominate an individual or team, in the Patient Award category of our Celebration of Achievement Awards, who has shown an exceptionally caring, supportive and compassionate service to patients, their families and friends.

Please note this category can only be nominated for by patients, relatives and visitors.


Staff can nominate colleagues who they feel have gone above and beyond their call of duty for our yearly Celebration of Achievement Awards.  The categories, criteria and links to the nomination forms are on StaffRoom.

About your nominee

Name of individual or team*

Role (if known)

Department/Ward

Site

Nominee's telephone number (if known)

Nominee's email (if known)


About you

Name*

Address

Your telephone number

Your email

Please use the space below to provide your supporting statement, please provide as much information as possible.*

We will be sharing your nomination with your nominee and we may also contact you if any further information is required.

Thank you for taking the time to complete a nomination. Should your nomination be chosen as one of the top 3 finalists, we may contact you to arrange to film a short clip about your nomination which, will be shown at the awards evening. You will also be invited to attend the presentation with a guest.

Would you be happy to make a short film clip for use at the awards presentation?*

* required fields

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Tour de Yorkshire takes place this weekend, starting in Bridlington on Friday.  Don’t get delayed if you need to attend NHS services for an appointment or otherwise; please check local radio for info on road closures and allow extra time for travelling.