Radiology Faculty Nomination Form

Department of Radiology and Imaging Sciences Faculty Awards Nomination
Please answer the questions below to nominate faculty for the 2022 Faculty & Staff Awards. Winners from the past three years are ineligible for nomination (click here to see list for past winners).
Please click here for past winners.
- Outstanding Patient Care Award- JuniorOutstanding Patient Care Award- SeniorOutstanding Mentor AwardOutstanding Contribution to Research Award- JuniorOutstanding Contribution to Research Award- SeniorOutstanding Service Award- JuniorOutstanding Service Award- SeniorRising (Radiology) Star AwardLifetime Achievement Award
- Junior – academic rank of assistant professor and the nominee having held this rank for no more than 5 years at Emory or another institution.
  
  Senior – academic rank of associate professor or professor and the nominee having held this rank for 5 or more years at Emory or another institution.
- Nominee's Name*
  
  First NameLast NameSuffix
- What is their title or division?*
- Your Name*
  
  First NameLast NameSuffix
- Your title and location:*
- Your E-mail Address*
  example@example.com

Outstanding Patient Care Award-Junior Faculty
Provides the highest quality patient careMaintains excellent rapport with non-physician clinical staffAdvances the quality of patient care (can include patients’ family members)Other
Describe how the nominee exemplifies the above selection(s)
Please attach in additional supporting information (optional)

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Outstanding Patient Care Award-Senior Faculty
Provides the highest quality patient careMaintains excellent rapport with non-physician clinical staffAdvances the quality of patient care (can include patients’ family members)Other
Describe how the nominee exemplifies the above selection(s)
Please attach in additional supporting information (optional)

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Outstanding Mentor Award
Please describe with examples how this person is an effective mentor for you and/or other faculty, learners/trainees, clinical or administrative staff.
Please attach in additional supporting information (optional)

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Outstanding Contribution to Research Award-Junior Faculty

Please describe the contributions the nominee has made to basic science, translational, and/or clinical research.
Please describe the contributions the nominee has made to basic science, translational, and/or clinical research.
Please attach in additional supporting information (optional)

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Outstanding Contributions to Research Award- Senior Faculty
Please describe the contributions the nominee has made to basic science, translational, and/or clinical research.
Please attach in additional supporting information (optional)

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Outstanding Service Award-Junior Faculty
Service to the three pillars: Clinical, Education and ResearchRecruitmentDevelop or advance innovative programs within the departmentSupports Diversity, Equity, and Inclusion or WellnessPatient outreachOther
Describe how the nominee exemplifies the above selection(s)
Please attach in additional supporting information (optional)

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Outstanding Service Award- Senior Faculty
Service to the three pillars: Clinical, Education and ResearchRecruitmentDevelop or advance innovative programs within the departmentSupports Diversity, Equity, and Inclusion or WellnessPatient outreachOther
Describe how the nominee exemplifies the above selection(s)
Please attach in additional supporting information (optional)

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Rising (Radiology) Star Award
Clinical careResearch activitiesTeaching/training activities within the department (over the past year)Received awards on a national level (over the past year)Other
Describe how the nominee exemplifies the above selection(s)
Please attach in additional supporting information (optional)

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Lifetime Achievement Award

The person should have been a member of Emory Radiology for at least 10 years.
Clinical practiceResearchTeachingService to the department and/or the field of radiologyLeadership within or on behalf of the departmentOther
Describe how the nominee exemplifies the above selection(s)
Please attach in additional supporting information (optional)

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Department of Radiology and Imaging Sciences Faculty Awards Nomination