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ROSE Award
This award is given in select locations. If you don't see your location, browse other ways to
recognize a caregiver
or use our
Contact Us form
.
Patient Care Technicians (PCT) Information
Patient Care Technicians Name
Hospital Name
Patient Care Technicians Unit
What location should your submission be directed to?
Please select...
Des Moines, IA
Fort Dodge, IA
Grinnell, IA
Marshalltown, IA
Sioux City, IA
Waterloo, IA
Please select the regional area you received care in.
x
Your Information
Your Name
Phone Number
Email
How do you prefer to be contacted?
Please select...
Phone
Email
No preference
Which option best describes you?
Please select...
Patient
Family/Visitor
Nurse
Physician
Team Member
Volunteer
Other
Reason for Nomination
Please describe a situation or story involving
the patient care technician you are nominating that clearly demonstrates his/her commitment to delivering extraordinary and compassionate care.
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