1. Who would you like to nominate?
Name of employee you would like to nominate
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First Name
Last Name
TPMG Practice
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TPMG Practice City
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2. Tell us about your experience
Please tell us about your experience and the reason you would like to nominate the employee in at least five sentences or more. To stand out, share examples of how the employee demonstrates TPMG’s core values of Excellence, Compassion, Belonging, Diversity, Professionalism, and/or Innovation :
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3. Your Information
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Phone Number (Optional)
Please enter a valid phone number.
Format: (000) 000-0000.
Are you a TPMG employee or patient?
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Please Select
Employee
Patient
Office Manager
*
Send Nomination
Should be Empty: