Exemplary Teaching Award

Exemplary Teaching Award

Please complete all of the fields shown below to the best of your ability:

YOUR NAME AND INFORMATION:

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Medical School/Residency Program:

NOMINEE NAME AND INFORMATION:

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Tell us why you wish to nominate this Family Physician for the Exemplary Teaching Award in a few sentences, bullet points, or a few paragraphs. Describe an experience or innovative teaching practice, a teaching moment or patient interaction, or generally how this person helped and inspired you along your path to becoming a physician: