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2026 Patient Choice Staff Awards Nomination Form

Page 1

Please use this form to nominate individuals/teams for going above and beyond for this year's Herefordshire and Worcestershire Health and Care NHS Trust staff awards.

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Question 1.

Your full name

- Required.
Question 2.

Your contact information

*
Question 3.

Name of the person or team you're nominating

- Required.
Question 4.

Their job title(s) if known

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Question 5.

Reason for your nomination

Please give a brief explanation (no more than 150 words) as to why the individual/ team deserves to win the chosen award category, including example(s) that explicitly link back to the award category

- Required.
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Question 6.

I consent for Herefordshire and Worcestershire Health and Care NHS Trust to contact me for further information about my nomination

- Required.