Power of 1 | Thank Your Doctor, Nurse or Other OhioHealth Associate

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OhioHealth Recognition Form (Power of 1)

Patients, Families and Visitors

Nominate an OhioHealth Associate for Excellent Service

If you would like to thank a doctor, nurse, or other patient care associate for excellent care or customer service, a Power of 1 nomination is a great way to let them know they are appreciated.

* Indicates required information

Today's Date * *

Associate's Name (One associate only, first and last name) * *

Department / Unit Name *

Location

Berger Hospital

Corporate

Doctors Hospital

Dublin Methodist Hospital

Grady Memorial Hospital

Grant Medical Center

Grove City Methodist Hospital

Hardin Memorial Hospital

Mansfield Hospital

Marion General Hospital

McConnell Heart Health Center

Nelsonville

O’Bleness Hospital

OhioHealth at Home

Physician Office

Rehabilitation Hospital

Riverside Methodist Hospital

Shelby Hospital

Other (enter below)

Other *

Please describe the action you observed. * *

Please check Customer Experience Standards that apply.

Treating all people with courtesy and respect

Showing care and compassion in everything I do and say

Connecting with every person to build a trusting relationship

Seeking to understand needs and striving to exceed expectations

Keeping the patient at the center of everything WE do

Nominator's Name * *

Nominator's Phone Number (optional) *

Nominator is: *

Patient

Physician

Family Member

Visitor

Thank you for your part in recognizing the efforts of our valued OhioHealth Associates!

TTY/TDD telephones (Relay No. 711)

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