2025 NCCY Nomination Form - The Schwartz Center

Your Information
Please tell us about yourself.
Your Name*
Prefix First Last Suffix
Your Organization
(if applicable)
Your Email Address*
Your Email Address Confirm Your Email Address
Your Address*
Your Street Address Your Street Address Line 2 Your City Your State / Province Your Zip / Postal Code Your Country
How did you hear about the award?*
Other:
I am a:*
Other:
Nominee
Please enter the caregiver's information below.
Nominee's Name*
Prefix Nominee's First Name Nominee's Last Name Nominee's Suffix
Nominee's Profession*
Nominee's Other Profession*
Nominee's Organization or System*
Nominee's Email Address*
An accurate email address for your nominee is very important. All nominees will be notified using the email address you provide for them. The Schwartz Center will email your nominee a link to the form they need to complete to be considered for the NCCY Award.
Nominee's Email Address Confirm Nominee's Email Address
Nomination*
Please share why this person should be selected as a National Compassionate Caregiver of the Year, highlighting why this healthcare professional is an extraordinary and compassionate caregiver. Please give examples whenever possible. Award criteria can be found here. We strongly suggest that you save your nomination letter in a Word or Google doc in case there are technical issues during the submission process.
Word Limit: 500

Your Information