Name of Nominee:		Department:
Submitted By:		Department:

SPIRIT VALUES EXHIBITED: Please select one statement for each SPIRIT Value.

Service:

Responded to customer concerns effectively Responded to customer concerns with enthusiasm and urgency Anticipated customer concerns and responded accordingly

Performance:

One step ahead, consistently evaluated situation and thought of creative ways to improve situation Delivered efficient, high quality service Delivered high quality service making improvements to processes to ensure outstanding performance

Innovation:

Generated creative/valuable idea leading to a new or improved process Sought ideas and suggestions from self or others to improve Hospital Brought attention to a problem. Created awareness that change was needed

Respect:

Interacted in respectful manner Demonstrated concern and openness toward customer ideas and feelings and used customer input in decision making Valued, accepted, and honored dignity of internal or external customer

Integrity:

Showed concern for and acted on concerns of others. Identified situation of conflict and acted Acted on concern for self-credibility by being personally accountable for doing the right thing Demonstrated concern for self-credibility and acted ethically

Teamwork:

Assisted team in achieving goal/resolution Promoted creativity within team and worked toward a resolution Pioneered creativity within team and led team to goal/resolution

Please answer the following Questions:

1. Did the action/contribution exceed expectations beyond the       Associate's regular job responsibilities?	YesNo
2. What level of initiative did the Associate take beyond       normal expectation?	AverageHighExtremely High
3. Please rate the benefit of the action/contribution to the       organization.	AverageHighExtremely High
4. Please describe who the contribution impacted (Check all        that apply).	IndividualOrganization Team / DepartmentCommunity

Please describe the SPECIFIC EVENT detailing how the Associate has gone ABOVE AND BEYOND
their normal job responibilities

Please describe the OVERALL QUALITIES that make this Associate eligible for a WOW Service nomination