Do you know someone who.... Steps outside of their comfort zone to do something to achieve their optimal contribution to patients, families, their team or themselves Someone who takes a bold risk to change practice, the environment or self ? Someone who stands up for patient advocacy or healthy work environment stds? Someone who dares to dream, act, change or lead? If you answered yes, we invite your nomination! Please complete this short survey. Nominees do not have to be a member to win. We will recognize one member who “Dares to” each month. Each winner will receive a one year national and GRAC membership ($98.00 value) Nominee’s Name___________________________________________ Nominee’s Hospital ________________________________________ Nominee’s /phone #____________________________________ Nominator ‘s Name _________________________________________ (Nominator must be Greater Richmond Area Chapter AACN member) Brief statement of how the nominee demonstrates the 2013 AACN President’s theme “Dare To… __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ _____________________________________________________________________