2022 Distinguished Advanced Practitioner Provider/Allied Health Professional Award Nomination Form
The North American Neuroendocrine Tumor Society (NANETS) Distinguished Advanced Practitioner Provider/Allied Health Professional Award recognizes and honors a member who has served NANETS in its efforts to educate healthcare providers and improve the outcomes of patients with neuroendocrine tumors. Please complete the form below as the Nominator.
Sign in to Google to save your progress. Learn more
Nominator Name *
Nominator Email *
Curriculum Vitae (CV)
Please send your CV to staff@nanets.net upon completing this form.
Nominee Name *
Nominee Email *
Nature of your relationship to the Nominee *
Required
Letter of Recommendation

Distinguished Advanced Practitioner Provider/Allied Health Professional Award Nominations will be evaluated based on several criteria:

  1. Dedication to their profession
  2. Track record of service to NANETS
  3. Contributions to the field in form of NET-related education, patient care, mentoring or research
  4. Dissemination of NET related knowledge in the form of meeting presentations, research papers, guidelines and/or adoption of NET-related care practices (e.g. PRRT clinic work flow, survivorship clinic, supportive care for carcinoid syndrome) by groups beyond home institution/group
  5. Commitment to diversity, equity and inclusion
  6. Serves as a role model for others by maintaining high standards of excellence 
*Nominees should meet several criteria,  but meeting all of them is not a requirement for selection or nomination.

Submit your Letter of Recommendation using the space below, please summarize the outstanding work and sustained contributions that demonstrate the nominee's commitment to their profession, NET medicine and diversity. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of NANETS. Report Abuse
Google Forms