Liberty Regional Medical Center : 2013 Dr. Whitman Fraser Award Nomination Form

2013 Dr. Whitman Fraser Award Nomination Form
Award Criteria: * Must be a current member of the Medical Staff of Liberty Regional Medical Center and have served for a minimum of 1 year. * Consistently provides exceptional patient care with the most advanced medical knowledge available. * Must exemplify and demonstrate the missions and values of Liberty Regional Medical Center, The Fraser Center, and Dr. Whitman Fraser. Click here to view our physicians’ section.
Other Considerations: Physician participates in community service as an active volunteer by donating personal time and involvement in support of charitable agencies/organizations and/or honorable cultural and community civic activities in the Liberty Regional Medical Center serving area. Other criteria to be confirmed and considered by the Selection Committee: Exemplifies an outstanding working relationship with the entire medical team of Liberty Regional Medical Center. May act as a champion or leader in initiatives that result in improved outcomes for patient care and/or staff relations. Nominations will be accepted until noon on Monday, October 15, 2013. Only one (1) entry will be accepted per person and/or email address.
	For the 2013 Dr. Whitman Fraser Award, I wish to nominate the following physician: Click here to view our physicians’ section
	Reason for nomination Please be very specific, keeping the award criteria in mind.
	Please provide us with your information below. This will be used only in the event there are questions regarding your nomination.
	Name
	Address
	City, State, Zip
	Phone Number
	Email Address