CAREGIVER NOMINATION FORM

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Heroes in the Home Caregiver Recognition Program
 
Thank you for nominating an unpaid caregiver as a Hero in the Home. To be eligible, your Hero must live within Hamilton, Burlington, Niagara, Haldimand Norfolk or Brant region and provide care to someone living in Ontario - see map.  
 
Before you begin, please be sure your nominee knows you are nominating them for an HNHB LHIN Heroes in the Home award and that you have their permission to go ahead with the nomination. See section 3 of the nomination form for details regarding permission and consent.
Important: Before completing the form please make sure you have the correct contact information for your Hero including current their address, telephone number and e-mail address. Also, please include as much information as possible about your Hero by answering all of the questions. View the nomination form here.

For more information about HNHB LHIN’s Heroes in the Home Caregiver Recognition program, please call 905-526-3611 or 1-866-790-4642 extension 3611.

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