Do you know an outstanding Anesthesia Resident? Nominate him/her below for Somnia’s First Annual Anesthesia Resident of the Year Award! This year’s award recipient will receive an Amazon Echo. 

Deadline for submissions is midnight, Friday, April 13, 2018. The winner will be announced on Wednesday, April 18 2018.

*1.Your Name(Required.)

*2.Your Email Address(Required.)

*3.Your Phone Number(Required.)

*4.Your Employer & Job Title(Required.)

*5.May we let the nominee know you nominated him/her?(Required.)

Yes 

No

*6.Nominee's Name(Required.)

*7.Name of school nominee attends(Required.)

*8.Name of facility at which nominee practices(Required.)

*9.Nominee's Email Address(Required.)

*10.Nominee's Phone Number(Required.)

*11.Do you go to school with the nominee?(Required.)

Yes 

No

*12.Do you work with the nominee?(Required.)

Yes 

No

13.What qualities, characteristics, or work style make the nominee an outstanding Resident? How does s/he exemplify high-quality anesthesia care?

14.Please add any additional comments.