2020 OAFP Family Physician of the Year Nomination Form
This award recognizes family physicians that have exhibited extraordinary, beyond-the-call-of-duty merit, articulated and encouraged members and students to pursue the ideals of family medicine, and conveyed these ideals to the public.
Email address *
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
Phone *
Your answer
Who are you nominating? (First Last, and Designation) *
Your answer
Nominee Email
Your answer
Nominee Address
Your answer
Nominee Phone
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How does this physician provide their patients with compassionate, comprehensive, and caring family medicine on a continuing basis? *
Your answer
How does this physician enhance the quality of their community? *
Your answer
How does this physician act as a role model professionally and personally to their community, other health professionals, and/or residents and medical students? *
Your answer
How does this physician stand out among their colleagues? *
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Additional Comments
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