STARR Nomination Form

It takes one person to make a positive impact. Together, we want to acknowledge our STARRs at WMMC, those who are demonstrating our values and Standards of Behavior. Thank you for taking the time to nominate someone for having a positive impact on your experience at WMMC!

Instructions: Please fill out the following information to nominate an employee, provider or volunteer. Please note: entire departments are not eligible for nomination – please nominate an individual only.

For questions, please contact the STARR team at

  • Personal Information

  • MM slash DD slash YYYY
  • Nominee Information

  • Signature

  • MM slash DD slash YYYY
  • We may use your contact information to tell you about health-related benefits or services that may be of interest to you.