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Dr. James Wood Hicks Lifetime Achievement Award Submission Form

Eligibility Requirements

  1. All nominations must be submitted no later than August 3, 2026.
  2. The nominee must have been in practice for 15-20+ years, and locally practicing in the Central Florida area for at least 10 years.
  3. The nominee must have been a member of the Orange, Osceola, Lake, Sumter or Seminole County Medical Society or the Physicians Society of Central Florida during some point in their career.
  4. The nominee must still be living.
  5. The nominee must have made significant contributions to the local community throughout their medical career.

Award

  1. A custom award engraved with the recipient’s name.
  2. Complimentary registration to attend the Annual Meeting. 

Each nomination should include:

  1. Completed award nomination form signed by the nominator(s). (At least one nominator must be an active PSCF member).
  2. Supporting letter from nominator who is familiar with nominee’s contribution.
  3. Complete CV of the nominee including all professional achievements.

Please Note: The submission is not considered complete until we have received the completed form, letter of support, and CV of the nominee.  


Lifetime Achievement Nominee

Nominated By

If you prefer you may mail your letter and CV to 

Physicians Society of Central Florida

522 S Hunt Club Blvd # 412

Apopka, FL 32703

Attention: Lifetime Achievement 

Please Note: The submission is not considered complete until we have received the completed form, letter of support, and CV of the nominee.