2016 nomination call

Nomination Form

Step 1 of 9 - Nominator Information

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  • * Nominations for the 2016 awards are now open!

    The Hastings Center Cunniff-Dixon Physician Awards will be presented to physicians in recognition of clinical contributions and commitment to the cause of end-of-life medical care.

    Prizes in the amount of $25,000 will be awarded to one senior physician (20+ years in practice) and one in mid-career (8-19 years in practice) who have demonstrated an exemplary commitment to patients near the end of life through their doctoring, their research, and/or their service to their community. Three additional awards in the amount of $15,000 will go to early-career physicians (0-7 years) who have already demonstrated exemplary efforts with patients near the end of life.

    [Note: the amount of time in total practice will be counted, not the amount of time in this particular field.]

    Nominees must be licensed physicians practicing in the United States. Any individual or group -- including professional associates, patients, and their families – may submit nominations. Nominations submitted in prior years may be resubmitted.

    All nominations will require the following:

    1)A cover sheet with basic information identifying the nominator and nominee;
    2)A current CV or similar biographical sketch of the nominee;
    3)Brief (200-500 word) summaries of the nominee’s excellence in the areas of:

    a) Technical Competence
    b) Personal Integrity
    d) Active Engagement of Family and Friends
    c) Doctor-Patient Dialogue
    e) Team Work
    f) Summary

    Nominations for the 2016 prizes will be accepted through December 31, 2015
    Please take your time to go through all the steps of the nomination process in order to validate your nomination.

    ** Please Note: If you are using a computer associated with a hospital system, we have encountered problems with our online form due to security/firewall issues. In which case, you can just download our nominations form HERE and send it along with the CV to our email address HERE.

    We are continuing to try and make the nominations process as easy as possible for everyone. Thank you for your patience and understanding!

    1/9 Nominator's Information


    Please fill out this form as the nominator suggesting a nominee for the 2016 Award.