In partnership with Skagit Regional Health

Phone: 360-435-2133
TTY: 711


GEM Nomination Form

Thank you for taking the time to recognize

a co-worker or volunteer for

Going the Extra Mile!

gems

Please fill out the form below to send your GEM.  Please note:  email addresses of co-workers may be available in Outlook.  If you cannot locate an email address, or the recipient is a volunteer, please put “unknown” in the field and the GEM will be hand delivered.  Thank you!

 






Your Name (required)

Your Email (required):

A Gem for (name of recipient):

Recipient’s e-mail address:

For Going the Extra Mile by: