Zinnia Award Nomination Form

For Thomas Hospital

Personal Information

* Indicates Required Field
Name of the nursing assistant you are nominating:*

Please enter your name of the nursing assistant you are nominating.
Unit where this nursing assistant works:
I would like to thank my nursing assistant and share my story of why this nursing assistant is so special:
Your name:*

Please enter your your name.
Your phone number:

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You entered an invalid number.
Your email address:

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Please contact me if my nursing assistant is chosen as a Zinnia honoree so that I may attend the celebration if available.
I am:
Thank you for taking the time to thank your nursing assistant! If you have any questions, please call (251) 279-1508.

*** Thomas Hospital is the only Infirmary Health hospital participating in the Zinnia Award program ***