Submit a Nurse — Legacy Registry

Legacy Registry

Honor a nurse with dignity. Fields marked * are required.

Complete each section below. Your information is used only for verification and follow-up — never sold.

About you (submitter)

Your full name * Email * Phone (optional)

About the nurse

Nurse’s full legal name (or professional name) * State(s) of licensure (if known) Approximate years of service (optional) Obituary or memorial URL (if available) Documentation upload (obituary, death certificate excerpt, or other proof) PDF, JPG, PNG, or Word — max 10 MB. Required unless you provided a working obituary link above. Your relationship to the nurse * Optional biography (max 500 words) Optional photo JPG or PNG only. Published only if you consent below.