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DAISY Award nomination form

I would like to nominate:

as a deserving recipient of The DAISY Award. This nurse's clinical skill and especially her/his compassionate care exemplify the kind of nurse that our patients, their families, and our staff recognize as an outstanding role model. She/he consistently meets all of the following criteria:

  • 80% spent in direct patient care
  • RN or LVN
  • No Written Counseling in last 12 months
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.

Nominations received by the 10th of the month will be considered for the following month's DAISY Award.

Please submit questions or nominations to Becky Fuentes at Extension 5050 or


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