Great Bend Regional Hospital
"You Made a Difference" Awards
Nomination Form

Your Contact Information

Are you a GBRH employee? *

Who are you nominating?

Where do they work? *
Department *
Thank you for submitting a nomination! All entries received by the 20th of the month will be considered for that month's awards. Nominations received after the 20th will be considered for the next month's awards. Nominations are welcome at any time. 
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Thank you for nominating a GBRH employee!