Please click "OK" to proceed to the nomination form.

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* 1. Nominee:

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* 2. Nomination is for the following award(s):

Check the box for the award(s) you are nominating the above individual. Individuals may be nominated for more than one award.

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* 3. Nomination submitted by:

Nominator must provide their name and be a current SDSMA member or group of members. 

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* 4. Statement of nomination

Statement should indicate why the nominee should receive the award(s). Provide highlights of the nominee’s contributions to the field of medicine and/or the SDSMA, or any specific information related to the qualifications for the award(s).

Note: If you would like to submit any supporting materials (letters, testimonials, article clippings, pamphlets, CV, etc.), please email it to

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