Award criteria:

• This award will be awarded annually to a BC family physician who meets the criteria. He or she may also be nominated for the CFPC Reg L. Perkin BC Family Physician of the Year Award.
• A nominator is required.
• Nominee's Name*
• Name of Person
  Please provide name of the contact person for this nomination.
  First and Last Name
• City*
• Phone*
• Email*
• Is the nominee aware of this nomination?*
  • Yes
  • No
• Nominator's Name*
  First and Last Name
• CFPC Membership #
  if applicable
• City*
• Phone*
• Email*
• Reason for Nomination
  Please describe why the nominee should receive this award.
• Nomination Letter/Package

  Please upload a cover letter outlining why you are nominating this family physician, plus any supportive documentation, such as letters of support or other information about the nominee's work.

  Please upload all of your documents here.

  Valid upload file extensions: .doc, .docx, .pdf

  Maximum file upload size 350MB

  Drop files here or

  Accepted file types: doc, docx, pdf.
• How did you hear about this award?*
  • BCCFP newsletter or email
  • Division of Family Practice
  • Facebook
  • Twitter
  If other, please specify e.g. a colleague, health authority

• If you do not receive a confirmation email from BCCFP within two business days, please contact [email protected]