Virginia Family Physician of the Year Award

Request for Nomination

Please nominate a member of the VAFP for this prestigious award.  Nominees should:

1.         Provide his/her community with compassionate, comprehensive and caring medical service on a continuing basis.

2.         Be directly and effectively involved in community affairs and activities that enhance the quality of life of his/her home area.

3.         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.

4.         Be in good standing in his/her medical community.

5.         Be a member of the VAFP.

Award recipients will receive a commemorative certificate during the 2008 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 June 2, 2008. 

Nominee’s Name:
Address:
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Your Name:
Address: 
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Phone:

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