DCH Hospital Hero Nomination

Thank you for your nomination! Your nomination will only be made available to Dorset County Hospital staff and will not be made public.  However, there is an option to remain anonymous at the end of the form.

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* 1. Your name:

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* 2. Your email address or phone number:

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* 3. Are you a Dorset County Hospital member of staff?

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* 4. Nominee’s name (individuals and/or teams):

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* 5. Nominee's department or ward:

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* 6. Please tell us a story about the exceptional care or service.  Please remember to include as many details as possible about the event :-)

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* 7. Would you like this nomination to be anonymous?

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