Consent: Star Award nominations can be used in several ways for publicity purposes to celebrate the services we deliver. This includes but is not limited to, printed information, displays, exhibitions, Board papers, on our website and on social media for example.

By consenting, you agree that your nomination can be used in this way (we reserve the right to continue to use the nomination until you advise otherwise)*

Yes: I consent for my nomination to be used for publicity purposesNo: I do not consent to my nomination to be used for publicity purposes

Do you consent to your name being include in any external publicity?*

Yes: I consent to my name being included in any external publicityNo: I wish to remain anonymous for publicity purposes

Your nomination

I would like to nominate (please use the drop down menu)*

IndividualTeam

First name or team name*

Last name, if an individual

Are you happy for your nominee to know you have nominated them?*

Yes: I’d like them to knowNo: I'd like to remain anonymous to the nominee/team

If you have nominated a team, it would be really useful if you could please provide us with a contact name within the team

Their job title (if known)

Their email (if known)

If you have nominated a team, what is the approximate number of people in the team (if known)

Which ward or department do they work in?

Please use the drop down list to choose the site your nominee works*

Bridlington HospitalCommunity basedMalton HospitalNelsons CourtScarborough HospitalSelby HospitalSt Monica's HospitalWhite Cross CourtYork Hospital

Care Group

Care Group or department*

MedicineSurgeryFamilyCancerCorporate ServicesYork Teaching Hospital Facilities ManagementUnknown

Tell us how this team or individual has made a tangible difference, and gone that extra mile for patients, visitors or staff, while demonstrating the Trust's values of kindness, openness and excellence through their behaviours and their actions.*

About you

Your name*

Your email address*

Are you a*

ColleaguePatientRelativeVisitor

Click on the submit button to complete your nomination.