The Outstanding Filipino Physician 2021
This Nomination Form and supporting documents (Nomination Book) must be submitted on or before October 30, 2021.
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Email *
Who may be nominated?
The nominee should be a Filipino Physician (natural born or naturalized) who is at least 41 years of age before October 15, 2021. We are looking for those with professional ethical conduct and practices, leadership in the community, high personal integrity and self service to those in need. He should also have received awards and citations related to the medical profession. Recent and past achievements should manifest his compassion and dedication as well as patriotism for staying in the country to serve the community especially indigents and for making significant contributions to national development in general and public welfare in particular. We are looking for your hero, your mentor, your inspiration in the medical community.


Name of Nominee *
First and last name
Service to Humanity
Email *
Mobile number *
Date of Birth *
MM
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DD
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Place of Birth *
Citizenship *
Civil Status *
College & Graduate Studies (School/Year/Degree) *
Medical Field of Expertise *
Medical Institution/Hospital/Clinic *
Main Office/Position/Title *
Main Office (Address & Phone Number) *
Major Awards & Citations *
Affiliations & Organizations *
Outstanding Accomplishments/Published Works *
Why should the nominee be selected as TOFP 2021 Awardee? *
Nominator's Name *
Nominator's Mobile Number *
How did you learn about TOFP? *
Nomination Book: Additional Information and Proof of Accomplishments
Kindly email additional information and proof of accomplishments that clearly show how the doctor nominee testify through his life and work that "service to humanity is the best work of life". Place "TOFP 2021 Nomination Book (Name of Nominee)" on the subject and email to tofp2021@gmail.com and/or pma1903secretariat@gmail.com on or before October 30, 2021. The Gmail date and time stamp will be used in case of dispute. The additional information should not exceed 20 pages when printed using 12 points font on A4 paper (roughly 10,000 words). Minimum submission is 2,500 words or 5 pages.

Please include two digital photos (recent colored ID photo and one full shot in medical uniform) plus a signed letter from NOMINEE addressed to TOFP 2021 stating the following: "I hereby grant permission to TOFP to use the facts herein contained and those subsequently submitted. I undertake, barring any unforeseen events, to be present during any interview required by TOFP and if selected as one of the awardees for 2021 that I will attend the presentation during the awarding ceremonies. I likewise grant the TOFP committee to perform an independent verification of any of the facts herein contained including those in the nomination book for its accuracy."
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