Clinical Excellence Award – Bucksbaum Institute for Clinical Excellence

Bucksbaum Institute for Clinical Excellence Award

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Deadline to submit is December 1st, 2023. Please complete all sections for the physician you are nominating. Self-nominations are also welcome. Any questions or technical difficulties, please contact finglima@bsd.uchicago.edu

Nominee Name(Required)

First Last

Title

Organization

Email Address(Required)

Email Address Confirm Email Address

Address(Required)

Street Address Address Line 2 City ZIP Code

Supporting information for your nomination

Please include nomination letter and the nominee’s most recent CV.

Nomination Letter(Required)

Max. file size: 100 MB.

Please upload a Word or PDF document describing why you are nominating this person, specifically addressing his/her dedication to clinical excellence and the Doctor-Patient relationship, his/her ability to establish good doctor-patient relationships and teacher-student relationships based on mutual respect and collaborative decision-making, how he/she has demonstrated commitment toward mentorship of junior colleagues, residents and medical students, his/her engagement or leadership of efforts to reduce health disparities, and his/her scholarly research that demonstrates a connection to the four-part mission of the Bucksbaum Institute for Clinical Excellence. Please limit to no more than 1000 words.

Nominee's CV(Required)

Max. file size: 100 MB.

Nominator Information

Name(Required)

First Last

Email Address(Required)

Email Address Confirm Email Address

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