Resident of the Month – Nomination Form

Nominee Name (required)

Program Name (required)

PGY (required)

Your Name (required)

Your E-mail Address (required)

Reasons for nomination in detail (required)
"Please describe in 1-2 paragraphs with clear reasons why you feel this resident deserves the Resident of the Month Award. The winner will be decided by the PARIM executive at the next meeting."

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