Staff excellence awards nomination form

Complete this form to nominate a member of Whittington Health staff for a monthly excellence award.

Nominations close on the last day of the month. Nominations are considered by members of the executive team and one is selected to receive an award.

The nominee and the person who has nominated them are invited to a presentation of the excellence award. Awards are usually presented by Trust chair Steve Hitchins.

Please ensure all the fields marked * are filled in correctly

Nomination details :

Name of employee being nominated*

Nominee job title

Nominee department*

How?*

Why are you nominating this member of staff?*

How do they exceed normal expectations for the benefit of patients or carers? How have they gone that extra mile?*

Any other comments

Your details:

Name*

Email address*

Telephone*