2025 Caregiver of the Year Award Nomination Form

2025 Caregiver of the Year Nomination Form
Nomination Deadline: August 16, 2025

* Indicates required field

Nominator Name *

First

Last

Nominator Email *

Caregiver Name *

First

Last

Caregiver Email *

Total Years as a Caregiver *

Years with Current Agency *

Hours of Care Provided Per Week (Average) *

Agency Name *

City *

State *

What makes this caregiver exceptional? *

What impact has this caregiver had on their clients and families? *

What three words describe this caregiver, and why? *

Provide a story or example that illustrates this caregiver's compassion and dedication to serving clients. *

Please upload a photo of this caregiver. *

Max file size: 20MB

Submit Nomination

Eligibility

Direct care workers and frontline caregivers providing care and support for individuals in their homes home are eligible to be nominated.
Licensed caregivers such as RNs, LPNs, OTs, PTs, STs are NOT eligible.
For eligibility questions, contact [email protected].