CAPA PA Leader of the Year Award

This award recognizes a PA that works collaboratively with the healthcare team and promotes PA practice. Recipient must be a CAPA member. Selection for this award will be based on the following criteria:

• Evidence of mutual respect and trust

• Teamwork in providing care to patients

• Team, community or professional leadership

• Evidence of team community services

Nominator Name *

Nominator Email *

Nominee Name *

Nominee City *

Nominee Specialty *

Nominee Email Address *

Nominee Phone Number *

Recommendation - Please attach a letter of recommendation that describes why the PA nominated is deserving of this award. *

Supporting Documents - Please attach any other supporting materials (CV, articles, additional letters of recommendation, etc.) that would help the Awards committee in making a decision.

I confirm that the Nominee is a CAPA member. *

Yes

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