AH Central Valley South - The Daisy Award Nomination Form

The Daisy Award Nomination Form

Adventist Health Bakersfield, Adventist Health Delano, Adventist Health Specialty Bakersfield and Adventist Health Tehachapi Valley.
The DAISY (Diseases Attacking the Immune System) Award is an international recognition program that honors and celebrates the skillful, compassionate care nurses provide every day. The DAISY Foundation was established by the family of J. Patrick Barnes after he died from complications of the auto-immune disease ITP in 1999. During his hospitalization, they deeply appreciated the care and compassion shown to Patrick and his entire family. When he died, they felt compelled to say “thank you” to nurses in a very public way. Please say thank you by sharing your story of how a nurse made a difference you will never forget!
Hospital*
Please describe a specific situation or story that demonstrates how your nurse made a meaningful difference in your care. Please include his/her name and department.*
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 is chosen.
Your Name*

First NameLast Name
Your Phone Number*

Area CodePhone Number
Your E-mail*
I am (please check one)*

PatientVisitorRNMDStaffVolunteer
Name of nurse you're nominating*

First NameLast Name
Unit the nurse works on*
i.e., ICU, Stepdown, Telemetry, Labor & Delivery/MCC, NICU
By providing your details and clicking "Submit" you agree to:
- Receive communications from Adventist Health through email, SMS, text, or calls by an automated telephone dialing system for the purpose of Adventist Health maintaining its relationship with you and providing you information related to services you may be interested in.
- Adventist Health collecting and disclosing to third parties personal information and communications for the purpose of fulfilling your inquiries or requests for services or information.
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