Use this form to submit a nomination for a 2021 Kansas City Medical Society Award. The deadline for nominations is midnight, September 15, 2021. The honors will be presented at the 2021 Medical Society Annual Meeting this fall. Questions? Contact Annette Small, interim executive director, nominations@kcmedicine.org, 816-516-7476.

(Note: It is recommended that you compose your nomination statement first in a word processing program then copy and paste it into the form.)