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Young at Heart Nomination Form

Young at Heart Nomination Form

In 1992, the Texas Medical Association Young Physician Section created the Young at Heart Award to recognize a TMA physician member or group of TMA physician members who have provided exceptional guidance and support to the Section or to young physicians in general.

Nominations will be accepted from TMA Young Physician Section (TMA-YPS) members only through January 15, 2011. The TMA-YPS will consider all nominees and select the award recipient at Winter Conference. The award will be given during the House of Delegates opening session at TexMed.

To nominate an individual, please provide the following information: 

Nominee:   
Company:   
Address:   
City, State, Zip:   
Email:   
Nomination Submitted By:   
Nominator Email:   

Please explain why the nominee should receive the YPS Young at Heart Award:

 

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