Spirit of Caring Award Nomination Form

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Spirit of Caring Award Nomination Form

Eligibility Criteria

In order to be eligible for this award, the nominee must meet the following criteria:

Designated as Category 1 (100% on campus)
Full-time or part-time (no PRN or temp)
Employed for at least three months at UT Southwestern
In a non-executive role (i.e. Job title below Assistant Vice President)
No disciplinary actions in the past six months

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One manager, one nominee, several nominators

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Here we go! (nominator)

Fire away

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This employee is

eligible.

This employee was not eligible for the following reason:

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This employee reports to

Manager's Email

Ineligibility reason

This employee is not considered Category 1 (on campus full time.)

This employee is PRN.

This employee is a contractor or temporary staff.

This employee has not been employed at UT Southwestern for at least three months.

This employee has received a disciplinary action within the last six months.

This employee is a resident or fellow.

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Did they win?

Yes

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Thank you for your participation! This event has come to a close, but you can still recognize your valued colleagues via a PACT Card!

First Name*
Last Name*
Employee ID (optional)
Nominee Department*
Nominee Job Title*
Nominee email*

First Name*
Last Name*
Nominator Department*
Nominator email*

In 3-5 sentences, please tell us why the nominee deserves to receive this award. Here are some ideas to get you started:

How has this individual displayed a “Spirit of Caring” towards their colleagues and/or patients and their families while being on campus every day?
How has this individual gone above and beyond?
How is this individual living out the UT Southwestern values of compassion, innovation, teamwork, or excellence during this time?

* must provide value

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Spirit of Caring Award Nomination Form

Nominee Information

Nominator Information

Qualifying Remarks

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