First Name: Last Name:
1) Describe the present situation, condition, method or procedure to be improved. Please be specific.
2) What is your suggestion? (Please be specific) Describe the improvement and tell how it can be made. (If more space needed, please use back of form)
3) How will your suggestion improve the present situation or benefit Port Huron Hospital in total?
4) If money will be saved or generated, provide estimates of savings or revenues (if known).
Is this suggestion being made by more than one employee? Yes No
If yes, list all employees involved with suggestion below:
By submitting this form, I certify that I am an(a): Employee Physician Volunteer
at Port Huron Hospital. I have read and understand the eligibility requirements and rules stated on the Employee Suggestion Program page, and I agree that Port Huron Hospital shall have the right to make full use of my suggestion.
Port Huron Hospital • 1221 Pine Grove Avenue • Port Huron, Michigan 48060 • 810.987.5000
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