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Trillium Award Logo

Trillium Award Nomination

Thank you for taking a few moments to nominate a deserving Certified Nursing Assistant for the Trillium Award.

Salem Health Values

Excellence | Caring | Integrity | Accountability | Teamwork


Trillium Nomination Form

Nominee Information

Nominee First Name
Nominee Last Name
Where did you encounter the nominee? (Department, unit, hospital area, etc.)
Your nominee must excel in three qualities to be considered for the award: Compassionate Care, Exemplary Service and Continued Commitment to Excellence. In each of the sections below, please briefly describe examples of why your nominee deserves the Trillium Award.
Compassionate Care
Exemplary Service
Continued Commitment

Your Information

Your Name
Your Phone
Your Email

Which best describes you ?

If Other, please explain