The Patient's Choice Award 2025 Nomination form

This popular award aims to recognise individuals or groups whose commitment and dedication have ensured that exceptional care is delivered to our patients.

Name of the team/person you are nominating *

Ward/Department/Hospital *

Why are you nominating this team/person? Please give as much information as possible. *

What is your name? *

Your telephone number

Your Email Address *

My submission may be used for publicity purposes. Do you agree? *

If yes, would you be willing to use your name, or would you like it anonymised? *

Yes
No (I would like to remain anonymous)

Are you willing to be contacted for publicity purposes if your nominee is shortlisted? *

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The Patient's Choice Award 2025 Nomination form