NSCFP Award Nomination

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Please complete the required information marked with an asterisk. Completing the additional information is helpful, but not required.

If your nomination is successful, we will contact you via email to confirm your nomination and allow you to add more detail if preferred.

All CFPC members are invited to submit nominations for the NSCFP Awards. Healthcare colleagues, community leaders, and patients are encouraged to submit letters of support for any nomination.

Email *

Nominee Name: *

Which award would you like this nominee to be considered for?
*

Award of Excellence

Nova Scotia's Family Physician of the Year

Dr. Charles & Mrs. Jean Gass Lifetime Achievement Award

Nominee City/Community:
*

Your Name:
*

Your Email:
*

Reason(s) for this nomination:
*

Please give a brief summary/biography of the candidate or add any additional information:

Send me a copy of my responses.

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