To Be Eligible for Nomination, the Candidate:

Must be an anesthesiologist who has been an Active member in good standing in the Section on Anesthesiology in the OMA for a minimum of 10 years.

Provided significant service to the promotion of anesthesiology and/or its respective subspecialties in the Province of Ontario by having had an active role in:

  •  Clinical Service or Excellence
  •  Administrative and Leadership
  •  Education and Teaching
  •  Research and Scientific Work
  •  Humanitarian and Altruism

Is not a member of the current Executive or its committee(s)

May be active or retired.

The award will not be given posthumously.

Please fill out the form below or download a form here: OA Distinguished Service Award Form

Please mail the nomination form and supporting materials before August 1, 2017 to the administrative assistant for the Section on Anesthesiology, Emily Hill. She can be reached by email at eanderson@ontariosanesthesiologists.ca

 

How to Nominate        

  • Nominations for the Distinguished Service Award may be submitted by any Section member(s) of the Section on Anesthesiology in the OMA by completing this form.
  • One form is required for each candidate nominated and it must be received by August 1, 2017.
  • The nomination form may be manually copied or you may complete the form online at www.ontarioanesthesiologists.ca
  • Nominations and other supporting material are to be sent to the administrative assistant for the Section on Anesthesiology, Emily Hill.  She can be reached by email at eanderson@ontariosanesthesiologists.ca

Nominations shall contain extensive supporting documentation, including:

1.  Approved Nomination form.

2. Nominee’s curriculum vitae.

3.  A detailed letter indicating why you believe your candidate deserves this honour. Please stress his/her significant contributions to anesthesiology or its subspecialties.

4.  Additional letters of support from two (2) other members of the Section on Anesthesiology in the OMA.

Nominations rejected by the Selection Committee may be reconsidered at a subsequent meeting or if the nomination is resubmitted.

 Upon nomination, the nominee will be contacted to confirm acceptance of nomination, and to obtain additional information.

 

First Nominator Information *
First Nominator Information
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Address
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Nominee Information *
Nominee Information
I am proud to nominate the following for the Distinguished Service Award:
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This individual has provided significant service to the promotion of anesthesiology and/or its respective sub-specialties in the Province of Ontario by having had an active role in*:
Nominee Address
Nominee Address
Nominee Phone *
Nominee Phone
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