Employee Suggestion Form- Riccobene Associates

The Employee Suggestion program is designed to promote the communication of ideas, a forum to offer solutions enabling both the Company and its employees to benefit from positive morale, greater productivity, increased employee and patient satisfaction & safety/compliance.

Ideas/Recommendations will be submitted to Human Resources and members of senior leadership. Please allow up to 72 hours for reply.

Please keep in mind this is not a forum for filing complaints. We want to solicit your feedback on how we can improve processes, procedures, communication, etc. Your safety, well-being is at our utmost priority.

Name (Optional)

First NameLast Name

Office Location (Optional)

We highly recommend to put office location to better help us work on office specific solution as each office dynamic/situation potentially may be different.

Job title:

Today's Date*

Date

Phone Number:

Area CodePhone Number

E-mail Address:

Employee Suggestion Category*

Concern*

Please state the nature of your suggestion, including how it improves your job, the job of others, value to the patients

Proposed Solution*

Please provide a description of proposed solution

Benefits

Please explain the anticipated benefit to the company

Planning: Please outline the steps need to accomplish request

Other items to note

Additional Comments