Distinguished Alumni Nomination Form

The University of Florida College of Medicine – Jacksonville Distinguished Alumni Award is presented to the College of Medicine – Jacksonville residency or fellowship graduate who has achieved extraordinary success in their respective discipline and who has embodied the mission of the College of Medicine – Jacksonville.

Nomination criteria

  • The nominee must be a former resident or fellow who completed their training at the College of Medicine – Jacksonville and has not previously received the award. Nominees may be considered in future years with a new nomination form.
  • The nominee must exhibit accomplishments in one or more of the areas that mirror the mission of the University of Florida College of Medicine – Jacksonville: to heal, to comfort, to educate and to discover through quality health care, elimination of health disparities, medical education, innovation and research.

Nomination Instructions

  • Complete the following form as accurately as possible.
  • Please verify nominee contact information prior to submitting.
  • Nomination forms should be submitted online or via mail by March 12, 2025. Nominations for 2024 are currently open.
  • Printed forms may be completed and mailed to the Office of Development, 580 West 8th Street, P-20, Jacksonville, FL 32209.
  • Honorees will receive a special invitation to be recognized at the UF College of Medicine – Jacksonville's annual Celebration of Resident and Fellow Education and Research Day at the downtown Jacksonville campus held annually in June.
  • For questions or additional support, contact The Office of Development by emailing Development@jax.ufl.edu or calling 904-244-1090.

Nomination Form

The form is currently closed.