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FAFP Hall of Fame Nomination Form

The Florida Academy of Family Physicians (FAFP or Academy) Hall of Fame (HoF) was established in 2023 as a way to recognize any current or former FAFP member or non-physician affiliated with the FAFP who has had an indelible impact on the Academy and the specialty of family medicine throughout Florida. Candidates should embody the true spirit of family medicine by providing or supporting the delivery of exceptional care for patients, mentoring future family physicians, making lasting contributions to family medicine, and leading the profession in a way that places everyone’s best interests above their own. This dedication should be exhibited over the entire course of their careers and clearly stand apart from others.

Eligibility Criteria:
  • FAFP members who have a minimum of 10 years of FAFP active membership, either consecutive or in total, over the course of their career.
  • Non-physician candidates must have at least 10 years of service to the FAFP, either through employment or contracted status, and the family physicians of Florida.
  • Candidates can be living or deceased.
  • A maximum of two (2) nominees may be inducted per year

Questions should be submitted to Deborah Walker at dwalker@fafp.org or (904)-400-6294.
1.Name of individual completing application (include email address):(Required.)
2.Nominee Name (per eligibility requirements):(Required.)
3.Is the Nominee aware of the award submission?(Required.)
4.Nominee or family home address (include address, city, state and zip code):(Required.)
5.Nominee mobile number (if applicable)(Required.)
6.Nominee email address (if applicable)(Required.)
7.Please upload a copy of the physician's CV for review (limited to 5 pages):(Required.)
No file chosen
8.A minimum of one and a maximum of three letters of recommendation(Required.)
No file chosen