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Nomination Form

DAISY Award Nomination Form

Please tell us about yourself

I am
Please contact me if my nurse is chosen so that I may attend the celebration if available.

Downloadable Version of the Nomination Form


Example Story

"Our 88-year-old mother was a patient for 2 weeks. Mom was on a roller coaster; we never knew what to expect. Everything was new and frightening to us as we watched her struggle to live. Through it all, Tami was there, working tirelessly, diligently, helping Mom and us understand issues and ramifications. She patiently explained things to us, sometimes more than once, until we got it. Of utmost importance to her was Mom's comfort. Tami was also concerned about each of us as we went through our own emotional and exhausting roller coaster rides. We looked forward each day to seeing Tami. She obviously cared deeply for Mom. Tami became like family. I wanted to hug her hello and goodbye. Everyday her knowledge and skills were evident. Such as, for 1 tiny example, the day 02 saturation was dropping, chest tubes were in-Tami analyzed the best position to put mom into with those tubes to maximize 02 saturation. It worked. Tami's tireless, devoted, and skilled passion for our mother's well being made a huge impression on us. She stood out as a nurse willing and able to go beyond the normal call of duty."

Please click the submit Button when you are finished.

Thank you for nominating a Nurse for The DAISY Award here at
Santa Clara Valley Medical Center.