People’s Choice Award Nomination Form

Your name*
First name Surname
Phone*
Email*
What best describes you:*
- Therapy Focus client/customer
- Parent/guardian/family member
- Support worker or advocate
- Teacher or education staff
- Colleague (from another service provider)
- Health professional
If you are submitting this nomination on behalf of a Therapy Focus client/customer, please provide their full name:
Is this nomination for an individual or a team?*
- Individual
- Team
Therapy Focus employee full name*

List the full names of the Therapy Focus employees*

Click the plus button to add more names

What was challenging or difficult before you started working with the therapist/therapy team/suppot staff?*
What did the therapist/therapy team/support staff do to help?*
How are things different since working with the therapist/therapy team/support staff?*
Please select the Guiding Principle/s demonstrated in their work:
- Stronger Together
- Make Today Count
- Keep It Simple
- Be Courageous
- Make It Personal
- Be Exceptional
Learn more about our Guiding Principles. (link opens in new tab).
Is there anything else you would like to add?
Consent to share with therapist/s*
I understand that this nomination will be shared with the therapist/therapy team*
Consent to publish name*
I understand that my name and details of this nomination may be published for promotional purposes*

People’s Choice Award