BEE Award Form

Thank you for taking the time to nominate extraordinary patient care support staff.

Please describe a situation in which the support staff demonstrated at least one of the PETAL principles and made a meaningful difference. By submitting your personal information below, you authorize Self Regional Healthcare to use this information for purposes of award selection and presentation, which may include publication of this information in internal and/or external periodicals or notices.

(For more information about BEE Award and the PETAL Principles, visit the BEE Award information page before filling out the form.)