Excellence in Clinical Care

Open to

All employees in clinical roles such as Enrolled Nurse (EN), Registered Nurse (RN), Clinical Care Team Leader (CCTL) or Clinical Care Manager (CCM)

Criteria

Recognising employees who have made an outstanding contribution through:

Nomination form

* indicates a required field.

I would like to nominate:

Please ensure this person’s name is spelt correctly
Nominee full name*
First name Last name
What is their position?*
Other position:
Which Home or site are they located at?*
Their Home or site (other):
My details are
My full name:*
First name Last name
My Regis Home or site:*
My Home or site (other):
I am a:*
Would you like your nomination to be anonymous?*
- Yes, I'd like to remain anonymous (a copy of what I submit will be shared with the person, but they won't be told who submitted it)
- No, I'm happy for them to know (my name and submission can be shared with the person)
Nomination Response
In what ways has this person shown great clinical (nursing) skills in their everyday work?*
How does this person show kindness and care to residents?*
Please provide examples of how this person helped make care safer or better for residents?*
Highlight how this person developed their own professional development and help guide other staff to learn or improve their own care?*
Optional supporting attachments

Please note: if you have more than one attachment you need to upload them separately. Each file has a maximum size of 5MB.
Attachment 1
Max. file size: 5 MB.
Attachment 2
Max. file size: 5 MB.
Attachment 3
Max. file size: 5 MB.
Attachment 4
Max. file size: 5 MB.
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