Nomination Form

Want to recognize an RFGH staff person on going above and beyond?
Tell us about your story!*

The RFGH CARES Award was created to recognize RFGH staff who go above and beyond their job expectation(s) by exemplifying our Core Values:
Collaboration, Accountability, Respect, Excellence, and Service.

*Important: Do not enter any HIPAA-protected health information (PHI) or sensitive patient details in this form. Nominations should focus on staff performance without personal health data.

I am nominating:

From the Department:

Select the values described in this nomination:

Please describe a specific situation or story that clearly demonstrates how this staff member exhibited at least one of RFGH's Core Values:

Your Name:

Phone Number:

Email Address:

I am a (select one or more):

Patient Visitor RFGH Staff Member RFGH Volunteer

By submitting this form, you confirm that the information provided is accurate and consent to it being used for CARES Award nomination review only. All submissions are handled in accordance with RFGH privacy policies and applicable laws.