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Resident Wellness: Resident Champion Award
Resident Wellness: Resident Champion Award
Please enable JavaScript in your browser to complete this form.
Information on the resident being nominated for the award:
Name
*
First
Last
Program
*
PGY Level (e.g. PGY4)
*
Your information:
Name
*
First
Last
Email
*
Program
*
If you are a resident, indicate your PGY level
If you are a faculty member, indicate your position (e.g. program director, departmental education coordinator, etc.)
Nomination Letters
Resident Nomination letter
*
Maximum two pages, 500 words
Support letting from Program Director or Departmental Education Coordinator/Vice-Chair of Education or Chair of Department/Division Head
*
Additional support letter
Email
Submit