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Hospital or Clinic Name
If Home Care or Hospice, please specify and select 'Home Care/Hospice' for your regional area.
What regional area should your submission be directed to?
Cedar Rapids, IA
Des Moines, IA
Fort Dodge, IA
Quad Cities, IA & IL
Sioux City, IA
This will help ensure your questions are routed to the team best equipped to answer - select the region you received care in, or the region that is closest to you.
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Which option best describes you?
Reason for Nomination
Please describe a situation or story involving
the nurse you are nominating that clearly demonstrates his/her commitment to delivering extraordinary and compassionate care.
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