You can always press Enter⏎ to continue
The Daisy Award/Daisy Team Award
13
Questions
START
HIPAA
Compliance
1
Image Field
Previous
Next
Submit
Press
Enter
2
Nominee's Names
*
This field is required.
PLEASE LIST THE WYANDOT MEMORIAL HOSPITAL EMPLOYEES FIRST AND LAST NAME. IF NOMINATING A TEAM, PLEASE MAKE SURE TO LIST OUT ALL TEAM MEMBERS
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
3
PROGRESS- HAS THIS NOMINEE MADE WYANDOT MEMORIAL BETTER?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
4
RELATIONSHIPS- IS THIS PERSON HONEST, RESPECTFUL AND TRANSPARENT?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
5
OUTCOMES- DOES PERSON OPTIMIZE PROCESSES TO GET THE BEST RESULT?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
6
MAKE A DIFFERENCE- HAS THIS PERSON MADE A DIFFERENCE FOR PATIENTS?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
7
INTEGRITY- DOES THIS PERSON DO THE RIGHT THING?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
8
STEWARDSHIP- IS THIS PERSON A GOOD STEWARD OF RESOURCES?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
9
EXCELLENCE- DOES THIS PERSON PROVIDE EXCEPTIONAL CARE/SERVICE EVERY TIME?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
10
Please provide at least 4 sentences elaborating on why/how this outstanding employee/team deserves to receive this award! Please be as specific possible- specific examples, dates, and details are always appreciated.
*
This field is required.
PROGRESS – Better tomorrow than today- How has this employee made Wyandot Memorial better? RELATIONSHIPS – Honest, respectful and transparent in all interactions- OUTCOMES – Optimize processes to achieve better results MAKE- a difference INTEGRITY – Do the right thing STEWARDSHIP – Responsible use of all resources entrusted to us EXCELLENCE – Exceptional Care, Exceptional Service…Every Patient, Every Time Please provide at least 4 sentences elaborating on why/how this outstanding employee/team deserves to receive this award! Please be as specific possible- specific examples, dates, and details are always appreciated.
Explain why your nomination deserves the selected award
Previous
Next
Submit
Press
Enter
11
Your Name
*
This field is required.
PLEASE LIST YOUR FIRST AND LAST NAME
First Name
Last Name
Previous
Next
Submit
Press
Enter
12
Your E-mail Address OR phone number
*
This field is required.
PLEASE ENTER YOUR EMAIL ADDRESS OR PHONE NUMBER
Previous
Next
Submit
Press
Enter
13
Which best describes you status
*
This field is required.
Wyandot Memorial Hospital Employee
Wyandot Memorial Hospital Retiree
Community Member
Other
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
13
See All
Go Back
Submit