Preceptor of the Year Award
Nomination Form - submissions due by 7/1
The Preceptor of the Year Award honors a dedicated family medicine preceptor who goes above and beyond in mentoring and educating the next generation of family physicians. This individual will have demonstrated a passion for family medicine, a strong commitment to teaching, and a lasting impact on the students and/or residents they’ve guided.
Nominee Name
First Name
Last Name
Nominee Professional Title
Practice or Institution Name
Nominee Email
example@example.com
Eligibility Requirements (Confirm the following by checking the box)
Nominator Name
First Name
Last Name
Title/Role
Email
example@example.com
Relationship to Nominee
Describe how the nominee demonstrates excellence in teaching and mentoring future family physicians.
How has this preceptor made a meaningful impact on students and/or residents?
In what ways does the nominee go beyond routine expectations to support learners?
Provide any additional comments about why this nominee deserves the Preceptor of the Year Award
Thank you for taking the time to submit a nomination!
Questions - Contact Mary Beth Rogers at mary@arkansasafp.org
Submit
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