Samuel J. Crumbine Medal

Please take a few minutes to submit your nomination using this electronic Award Nominations Form. The Samuel J. Crumbine Medal is the most prestigious award given by KPHA. It is awarded for meritorious service and state, regional, or national recognition related to the improvement of the health of Kansans and/or the environment of the state. Recipients of other KPHA awards may receive this award.

If you would like to submit multiple names for this award category, please clink on the original link to access this form as many times as needed.

If you have any questions, please contact Daniel Craig at 785-452-4848 or

Nominations must be received by Friday, August 6th, 2021 for the September 2021 KPHA Conference.

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* 1. Contact information of KPHA member submitting the nomination

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* 2. Contact information for Nominee

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* 3. Briefly describe how the nominee meets the selection criteria for this award and your reasons for nominating this individual to receive this award.