State Affiliate of the American Psychological Association

Florida Psychological Association

408 Office Plaza Drive Tallahassee, FL 32301

• (850) 656-2222

2015Psychologically Healthy Workplace Awards Program

Nomination Form

The Florida Psychological Association (FPA) has established a program to honor and recognize the best companies and non-profit organizations in the State of Florida that reflect psychologically healthy policies, practices and environments for their people. This Psychologically Healthy Workplace Award (PHWA) program is designed to recognize organizations that make a commitment to programs and policies that foster employee health and well-being while enhancing their own organizational performances. In conjunction with the national program developed by the American Psychological Association (APA), this State of Florida programencourages all types of organizations to apply – small, medium and large, profit and non-profit, as well as government, military and educational organizations. The next cycle for our award will begin in November 2014 through June 2015 for applications.

We accept applications and nominations for this meaningful and prestigious award! In fact, we would welcome your assistance in identifying those organizations that are special and unique in how they operate, how they manage their people, and how they impact the lives of those that work with them. Our PHWA Committee looks at these five key criteria in assessing organizations:

Employee Involvement
Employee Growth and Development
Employee Recognition
Work-Life Balance
Health and Safety

Since its start five years ago, the Florida Psychological Association PHWA program has selected six state winners: Tallahassee Memorial Hospital (Tallahassee, FL), Saint Leo University (St. Leo, FL), Tykes & Teens (Palm City, FL), Team Horner Group (Fort Lauderdale), AvMed Health Plans (Gainesville), and Moore Communications Group (Tallahassee). Tallahassee Memorial Hospital also went to on to be recognized at the national level by APA for their outstanding policies and practices. We are proud of all of our PHWA recipients who demonstrate how organizations can focus on the welfare of their employees while conducting their business.

If you know an organization that is special and a “cut above” the rest, encourage them to apply or fill out the nomination form for them. All nominated organizations will be contacted by the PHWA Committee to discuss the application process and the many benefits of applying.

2015PHWA NOMINATION FORM

Florida Psychological Association

I would like to nominate the following organization to be considered to receive the Psychologically Healthy Workplace Award (PHWA) that is sponsored by the Florida Psychological Association. I understand the PHWA Committee will follow up and talk with the organization about this award program. Organizations must complete the application process no later than April 1, 2015.

Organization Information:

Name:

Address:

Contact Person: Position:

Phone Number: Email:

Date of Nomination:Number of Employees:

Person Making This Nomination Request:

Name:

Address:

Phone Number:Email:

Your relationship with the Organization:

Reasons For Nomination:

I am nominating this organization for the following reasons (check all that apply):

( )This organization has a solid community reputation for treating employees fairly.

( )This organization appears to have low employee turn-over and good morale.

( )Current and past employees speak highly about this organization.

( )This is one of those organizations that everyone wants to work for and takes pride in.

( )This organization values and promotes employee safety and well-being.

( )This organization is dedicated to and supports the community.

( )There is a positive feeling for the organization, and the employees appear to be happy.

( )To me, this place is a great place to work and is worthy of such an award.

( )Other:

Thank you for nominating this organization for the PHWA program award that recognizes those organizations that promote psychologically healthy environments. Please send back this sheet via email, scan or fax to the number listed below. You will be notified when your nominated organization has been contacted. Feel free to contact the Chairman of the PHWA Committee for more information. Also, to learn more, go to click About FPA and click Psychology in the Workplace.

James P. Atsaides, Ph.D., Chairman

Psychologically Healthy Workplace Awards Committee, Florida Psychological Association

Email: Phone: 410-913-4189 Fax: 941-388-0835