2021 Medical Society Service Awards: Nomination Form
Each year the Onondaga County Medical Society recognizes physicians, non-physician individuals and organizations for outstanding medical service and acts performed both within the medical community and the community at large.
The categories for service awards are found below. All awardees will be honored at this year’s fall Annual Meeting.
To recognize a worthy colleague, person or organization; submit their names and supporting information by August 25th, 2021. You can also email nominations to
or mail to: Onondaga County Medical Society, 125 E. Jefferson Street, Syracuse, NY 13202.
Your Contact Info (email AND cell phone)
So that we may contact you about your suggested award winner or if more information is needed
Full Name of Nominee/Suggested Award Winner
Award for Which to Be Considered
Physician Service to the Medical Society
Adeline Fagan, MD Physician Service to the Community Award
Service by a Retired Physician to the Community and/or the Medical Society
Non-physician Service to Medical Care (can be community member or staff member or organization)
Jerry Hoffman Advocacy Award
Distinguished Service Award
Are they an OCMS Member?
Reason for Nomination (Please describe below why this person should receive this award)
Any other information or links you would like to provide to support your nomination? You may also email additional documents to
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