Physician Kudos Entry Form - Vernon Physician Society

Your Name *

First

Last

Your Email Address *

Who would you like to nominate? Please provide the nominee’s first and last name, and department. *

the sent name,

Nominee's Email Address *

Checkboxes *

Please provide a short explanation of how this nominee went above and beyond, and why they deserve a ‘Kudos’. A copy of this section will be sent to the nominee. *

Have you noticed someone going above and beyond? Give them a ‘Kudos’ and a chance to win a prize!