Request for Nomination
Please nominate a member of the VAFP for this prestigious award. Nominees should:
- Provide his/her community with compassionate, comprehensive and caring medical service on a continuing basis.
- Be directly and effectively involved in community affairs and activities that enhance the quality of life of his/her home area.
- Provide a credible role model as a healer and human being to his/her community, and as a professional in the science and art of medicine to colleagues, other health professionals and especially, to young physicians in training and to medical students.
- Be in good standing in his/her medical community.
- Be a member of the VAFP.
Award recipients will receive a commemorative certificate during the 2017 VAFP Annual Meeting, land travel expenses, one night’s lodging and a $100 honorarium.
Complete the nomination form below and click SUBMIT. Nomination forms must be received no later than May 30, 2017.