SSVMS Honors Medicine Award Nomination Form
Please use this form to nominate a physician for one of SSVMS's annual awards. For questions, contact Chris Stincelli at cstincelli@ssvms.org.
To be considered for the 2027 SSVMS Annual Awards distributed at SSVMS Honors Medicine 2027, submit your nominations on or before July 31, 2026.
Your name
*
First Name
Last Name
Your phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Your email
*
example@example.com
Name of physician you are nominating
*
First Name
Last Name
Medical group or affiliation
Golden Stethoscope Award
Criteria: Candidates for the Golden Stethoscope Award shall be judged primarily for their devotion to patient care and the medical needs of the community in an environment of unselfishness, compassion and empathy. The candidates shall be members in good standing of SSVMS and may be active, retired, or hold an administrative position.
Community Impact Award
Criteria: This commendation shall be given to a member of the Sierra Sacramento Valley Medical Society whose high achievement has allowed a contribution of great significance to community health. The candidates shall be members in good standing of SSVMS and may be active, retired, or hold an administrative position.
Excellence in Advocacy
Candidates for the Excellence in Advocacy Award shall be judged primarily for notable leadership and/or advancement of healthcare policy that directly benefits physicians and patients. The candidates shall be members in good standing of SSVMS and may be active or retired.
Outstanding Medical Society Volunteer
Advancing the mission and vision of SSVMS through notable contributions to the Society, patients, or Bridging Medicine programs such as SPIRIT, Future of Medicine, the Museum of Medical History, and more. The candidates shall be members in good standing of SSVMS and may be active or retired.
I would like to nominate this physician/medical student for:
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Golden Stethoscope
Community Impact
Excellence in Advocacy
Outstanding Medical Society Volunteer
I would like the Medical Society to select the award that best represents their contribution to medicine
I would like to nominate a physician for:
*
Please Select
Golden Stethoscope
Community Impact
Excellence in Advocacy
Outstanding Medical Society Volunteer
I would like the Medical Society to select the award that best represents their contribution to medicine
Why should this physician be honored as the 2027 Golden Stethoscope Recipient?
Example: Jane Doe, MD should receive the Golden Stethoscope Award because of her outstanding dedication to patient care and the efforts she puts in to helping them understand the situation they're in. Some examples of this include...
Why should this physician be honored as the 2027 Community Impact Recipient?
Example: John Doe, MD should receive the Community Impact Award because of his outstanding commitment to improving the health and well-being of the broader community. Through his work both inside and outside of the clinical setting, he has helped address critical health needs, such as...
Why should this physician be honored as the 2027 Excellence in Advocacy Recipient?
Example: Jack Doe, MD should receive the Excellence in Advocacy Award because of his dedication to advancing policies and initiatives that both improve patient care and strengthen the medical profession. Some examples of this include...
Why should this physician be honored as the 2027 Outstanding Medical Society Volunteer Recipient?
Example: Jennifer Doe, MD should receive the Outstanding Medical Society Volunteer Award because of her extraordinary generosity in sharing her time, expertise, and talents with SSVMS/Bridging Medicine. For example, she has...
Why should this physician be honored as an award recipient?
Example: Jessica Doe, MD should be recognized for her exceptional contributions to her patients, to medicine, and to her community. Throughout her career, she has demonstrated leadership, compassion, professionalism, and a commitment to making a meaningful difference in the lives of others. Some examples of this include...
Other comments - what other things should we know about them?
Submit
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