Northern Ireland GP of the Year Award

Fields marked with an Asterisk* are mandatory

Nomination form
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GP and Practice details
Are you a patient of this GP?


Reason for nomination

When preparing your answer please consider the following:

What qualities do you feel make your GP special, please highlight any outstanding contributions or commitments the GP had made to your care.

How have they made a difference to your life? Please give examples of how they have impacted on your quality of life and action(s) taken that you feel are above and beyond the call of duty.

In no more than 500 words please tell us:

Please rank below the qualities which you believe best describes your GP with 1 being the highest
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Caring
Good listener
Builds confidence and a trusting relationship quickly
Takes time to explain things making sure I understand
Communicates in clear but sensitive manner
Takes additional interest in whole family
Does what they can to make my life better with illness
Investigates all areas of illness/complaint thoroughly
Is always up to date on the treatment of a condition
Always considers my medical history when treating me
Makes links with other care professionals to help with my treatment
You and your GP
Please complete the section below
GPs who are nominated may want to see their nomination. Do you want your GP to see your nomination?



For your information

RCGP Northern Ireland may reproduce an anonymous version of your nomination for promotional purposes.

Patients will not be identifiable in the text used.

Do you agree to this?


Please complete the consent and declaration

Please enter your name below if you consent to information provided in this form, or photographs taken at the RCGP Northern Ireland GP of the Year Award event

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