SCFP Award of Excellence- Nomination Form

Award of Excellence

Nomination From
The Award of Excellence recognizes CFPC members who in the past 12 – 24 months have made an outstanding contribution in one or more of the following areas: patient care; community service; hospital or health care institutions; College activities (National or Chapter); teaching; research; or other elements of the academic discipline of family medicine. This award is based on nominations from peers or members of the public and all who meet eligibility are welcome to submit a nomination

Examples of outstanding contributions may include but are not limited to the following:

•Charitable or humanitarian work
•Outstanding teaching
•Excellence in clinical practice
•Innovative research program
•Leadership during community outbreak of infectious disease
•Establishment of training program in family violence
•Innovations in developing a new program to address a health care need
•Leadership role in a hospital or regional health care program

Eligibility Criteria

• Nominee must be a member of the Saskatchewan College of Family Physicians (SCFP) and the College of Family Physicians of Canada (CFPC) in good standing for at least one (1) year.

• Contributions being recognized must have occurred within the past two (2) years (24 months).

• Nominee must not be a current member of the SCFP Board of Directors or the SCFP Honours & Awards Committee at the time of nomination.

• Nominee must not have previously received the SCFP Award of Excellence (to the best of the nominator’s knowledge).

• Nominations may be submitted by a peer, colleague, learner, patient, or member of the public.

Submission Deadline: March 31, 2026.
1. Nominator Information
Nominator's Name*

First NameLast Name
Nominator's Phone Number*

Area CodePhone Number
Nominator's Email*
example@example.com
2. Nominee's Information
Nominee's Name*

First NameLast Name
Mailing Address*
Postal Code
Nominee's Email*
example@example.com
Telephone
3. Questionnaire

Nominations are assessed based on the completeness and strength of the information provided. The committee will review the responses to the questions below, together with any additional supporting materials submitted.
Please identify the specific area(s) in which the nominee has made outstanding contributions in the past 24 months.

Clinical practiceCharitable or humanitarian workinnovative research programLeadership during a community health crisisEstablishing or developing a healthcare programLeadership in a hospital or region healthcare settingTeaching
Other
Describe how their efforts have made a positive impact*
Provide a specific example where the nominee has gone "above and beyond" the expectations of a family physician.*
Explain why this nominee deserves the recognition of Excellence Award*
Upload Supporting Documents

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Award of Excellence

1. Nominator Information

2. Nominee's Information

3. Questionnaire