2026 UAFP Family Medicine Physician of the Year Nomination Form

Nominate a deserving colleague for the UAFP Family Physician Legacy Award!

Nominate a deserving colleague for the UAFP Family Physician Legacy Award!

The Family Physician Legacy Award honors a family physician whose career has made a lasting difference in the lives of patients, the Utah community, and the specialty of family medicine.

This physician has spent years providing compassionate, comprehensive, and caring family medicine, and has remained a trusted presence in their patients’ lives. They have been a leader in their community and in the profession, a role model to colleagues, residents, and medical students, and an example of the family physician’s role in improving the health of Utahns. Their influence will be felt for generations.

To complete this nomination, please either:

Answer the questions below directly in this form, or
Upload one to two (1-2) letter(s) of nomination that address the same points.
Letters may be written by an individual or a committee/group.

Whichever format you choose, please be sure to address the nominee’s:

Current or most recent practice location
Career accomplishments and activities over time
Exceptional qualities that make them a leader among family physicians
Lasting impact on patients, the community, and/or the specialty of family medicine

Criteria on which nominees will be considered include:

A sustained record of excellence in patient care
Long-term contributions to the profession of family medicine
Leadership and service over the course of a career, which may include practice leadership, community service, scholarly activity, advocacy, mentorship, or education
Commitment to the principles of equity, diversity, inclusion, and belonging
Lasting impact and legacy

Nominations not selected for the current year will be considered again for the following two nomination cycles.

Please note, nominees must be current active members of UAFP. Contact us if you’d like us to check the membership status of your nominee.

Question 1: Describe the nominee’s career-long commitment to compassionate, comprehensive patient care and to the practice of family medicine. Please include specific examples of how they have been a trusted, ongoing presence in their patients’ lives over time.

Question 2: How has this physician served as a leader and role model throughout their career, whether through community service, advocacy, mentorship, scholarly work, or commitment to equity and inclusion? How have their contributions strengthened their community, their patients’ health, or the specialty of family medicine?

Question 3: What legacy has this physician built? Please share a story or example that shows the lasting difference they have made, and what it reveals about why they deserve this honor.

Your Name

First NameLast Name

Your Email

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Your Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Name of Nominee

First NameLast Name

Nominee's Email

example@example.com

Nominee's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Upload 1st Letter of Nomination (LETTERS ONLY NEEDED IF QUESTIONS ABOVE NOT COMPLETED)

Upload 2nd Letter of Nomination (LETTERS ONLY NEEDED IF QUESTIONS ABOVE NOT COMPLETED)