MHH Organic DAISY Award Nomination Form-2853479

Want to Say Thank You To Your Nurse?

Share Your Story!

The DAISY (Diseases Attacking the Immune System) Award is an international recognition program that honors and celebrates the skillful, compassionate care nurses provide every day. The DAISY Foundation was established by the family of J. Patrick Barnes after he passed away from complications of the auto-immune disease Idiopathic Thrombocytopenic Purpura (ITP) in 1999. During his hospitalization, they deeply appreciated the care and compassion shown to Patrick and his entire family. When he passed away, they felt compelled to say “thank you” to nurses in a very public way. Please say thank you by sharing your story of how a nurse made a difference you will never forget!

If you have any questions, please contact: HarborDaisy@medstar.net

Each DAISY Award Honoree will be recognized at a public ceremony on his/her unit and will receive: a beautiful certificate, a DAISY Award pin, and a hand-carved stone sculpture entitled A Healer’s Touch. Additionally, everyone on the unit will celebrate with Cinnabon^®cinnamon rolls—a favorite of Patrick’s during his illness. The Barnes family asks that whenever and wherever nurses smell that wonderful cinnamon aroma, they stop and think about how special they are.

If you or a loved one had a successful patient experience that you would like to share with others, please fill out the form below.

To Nominate an Extraordinary Nurse

Anyone may thank a deserving nurse by filling out this form.

Name of the nurse you are nominating

First Name

Last Name

Unit where this nurse works

I would like to thank my nurse and share my story of why this nurse is so special

Thank you for taking the time to thank your nurse.

Submitter

First Name

Last Name

Phone Number

Email

City of Residence

Please contact me if my nurse is chosen as a DAISY Honoree so that I may attend the celebration if available.

Yes No

I am (please check one):

Patient Family

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