Practice Recognition Award Program

Your Name *

Your Institution *

Practice that is being recognized * The name of the practice exactly as it should appear on the certificate and letter of congratulations.

Full Name of Person at practice to whom letter should be addressed * The full name of person at practice exactly as it should be printed on the certificate and letter. Example: John M. Smith, PhD

Last Name of Person at Practice The last name of the person at practice exactly as it should be printed in the salutation of the letter. Example: Smith

Person at practice’s street address *

Person at practice’s city, state, and zip *

Title for letter salutation *

Check each box to indicate practice you’re nominating has met the criteria:

Demonstrates a culture of support for the education of primary care providers. Leadership communicates that participation in education benefits the practice and patient care. *

Welcomes learners and allows them to participate meaningfully as members of the health care team in roles appropriate to their level of training. *

Has precepted a reasonable number of students (based on size) for at least the past two years. *

Has implemented patient-centered practices and processes. *

Provides comprehensive care for children and adults, defined as both acute and chronic care, preventive services, and end-of-life care *

Allows students to write patient encounter notes in the EHR. *

Submit

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Leawood, KS 66211

800.274.7928

Email: stfmoffice@stfm.org

Events

September 20: Residency Curriculum Resource Webinar

December 5-8: Conference on Practice & Quality Improvement

January 19-25: STFM/MEDICC Trip to Cuba

January 30-February 2: STFM Conference on Medical Student Education

Deadlines

September 9: Call for proposals for the STFM Annual Spring Conference closes

September 9: Call for applications for the STFM Program Assessment Chair closes

September 13: Call for applications for the Task Force to Develop Guidelines for Protected Non-Clinical Time for Faculty closes

September 13: Call for applications for Work Group Leaders for URM Initiative closes

September 15: Last day to submit curriculum for the National Clerkship Curriculum

September 17: Deadline to apply for the Advocacy Scholarship for New Faculty

October 1: Applications due for STFM/MEDICC Trip to Cuba

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Practice Recognition Award Program

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