The DAISY Award for Extraordinary International Nurses
Nomination Form
The DAISY Award is an international recognition program started in memory of J. Patrick Barnes. Pat’s family experienced first-hand the difference his nurses made in his care through clinical excellence and outstanding compassionate care. The family created The DAISY Award to express gratitude to nurses and to enable other patients, families, and staff to thank and honor their special nurses. A branch of the DAISY Award, the DAISY International Neuroscience Nurse Leadership Award, is awarded by a WFNN Executive Board member at an annual neuroscience symposium, conference or event.
Please visit DAISYFoundation.org to learn more about Pat’s story and how The DAISY Award recognizes Extraordinary Nurses.
Complete this form to share your story of how a neuroscience nurse leader made a difference in and impacted the field of neuroscience nursing. https://app.roundsplus.getwellnetwork.com/SurveyAction/SurveyGo/ugjUw1yrQe3Du
1. First and last name of the nurse you are nominating:
2. Name of the national organization with which the nurse performs a majority of their work or volunteerism.
3. City and country where the nominated nurse works:
4. The role/position (s) held by the nominated nurse:
5. Please describe a specific situation or story that clearly demonstrates how this nurse made a meaningful difference in the field of neuroscience nursing. Note: If using a mobile device to enter this E-Nomination you can easily enter your story by selecting the microphone button on your device and dictating your story instead of typing.
6. Is there anything else you would like the selection committee to know about the nurse you are nominating?
Please tell us about yourself:
7. I am a: peer/colleague, manager, patient/family member of a patient
8. Your name and relationship to the nominated nurse:
9. Your contact email address:
10. By submitting this online form, you agree to The DAISY Foundation and/or its partners collecting and storing the information you submit, including your personal contact information, following the DAISY Foundation Privacy and applicable law. The DAISY Foundation or the organization where your nurse works may contact you with questions about your submission. To learn more, please read the Daisy Foundation Privacy Policy.
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Please click the “Submit” button when you are finished entering your DAISY E-Nomination.