Public hospital of choice Entry Form - Quality Health Care Awards

ENTRY FORM

PUBLIC HOSPITAL OF CHOICE

Name*
First Last
Email*
Name of the Public Hospital you wish to nominate*
Location of the hospital*
Reason for nominating the Hospital?*
- Timely care
- ‌Respectful and dignified care
- Involvement in decision making‌
- Confidentiality of personal information
- Quality basic amenities /Clean, safe and comfortable environment
- ‌Freedom to choose a healthcare provider
- ‌Social support
(SELECT ALL THAT APPLY)
Would you like to add anything?

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