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NM Star Award Nomination Form – Suburban Physician and Medical Offices

Name of employee you would like to thank (first name, last initial, last name if known)

Department or unit where this employee works

Employee's role (if known)

Describe a situation or story that shows how the employee made a difference in your experience.

Thank you for taking the time to nominate an extraordinary employee for this award. Please tell us about yourself.

Your information will only be used for the purpose of this nomination and will not be shared with third parties.

I am a

Your full name

Phone number

I give permission for my name to be shared with the nominating committee for this award. I acknowledge my name may be shared during the presentation of this award. Yes No

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COVID-19 and flu vaccines are now available. Find out how to get them at a location near you.

NM Star Award Nomination Form – Suburban Physician and Medical Offices

Thank you for taking the time to nominate an extraordinary employee for this award. Please tell us about yourself.

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