Bridge Health Employee Nomination Form

OUR VISION

Partnering with individuals throughout their journey to health, healing, and recovery.

OUR MISSION

Our purpose is to partner with individuals and communities to improve lives by providing services that can lead to transformation.

Employee of the Quarter & Year Nomination Submission

This is an award to recognize Bridge Health staff who provide extraordinary service to the agency and to the community served by Bridge Health. Anyone staff may nominate a staff member for this award. Nominees must have completed at least six months of employment at Bridge Health. Award recipients will be announced on the last day of each quarter. Past recipients can receive this award every ten years. There is no limit on the number of individuals you may nominate. Please submit a separate form for each nominee.

Nominator Information *

First Name Last Name

Phone Number

Area Code Phone Number

Email

example@example.com

Relationship to the nominee (e.g. coworker, supervisor, etc.)

Nominee Information *

First Name Last Name

Nominee's current job title

Noninee work location

Month Nomination Submitted:

How does this individual exemplify and live out the mission and vision of Bridge Health?

Nomination Criteria

Please choose AT LEAST THREE of the below examples and give a detailed description for each example. You may describe more than three but at least three must be filled in for the nominee to be considered.

Effort was "above and beyond" job responsibilities...

Demonstrated extraordinary leadership and/or teamwork skills...

Inspired others to do their best; offered techniques and/or unexpected time and energy to assist others with no expectation of recognition...

Contributed exceptionally to a project...

Reacted positively to an urgent situation or individual in crisis...

Are there any additional reasons you would like to nominate this person?

Once you complete this form, click on the "Submit" button below. This will then email you a copy of the submission, which is also emailed to the Bridge Health Culture Committee.