2026 Chapter Awards | Maryland Chapter of ACEP

2026 Chapter Awards Submission Form

The Maryland ACEP Chapter is now accepting nominations to honor individuals who have made exceptional contributions to emergency medicine. This is your chance to spotlight colleagues who exemplify excellence, leadership, and dedication to our specialty. Let’s recognize those who inspire us and elevate the standard of care in our community!

Nominator Information

Name(Required)

First Middle Last Credentials

Email(Required)

Enter Email Confirm Email

Preferred Contact Method(Required)

Are you a member of the Maryland ACEP Chapter?(Required)

Hospital Affiliation

Name of Hospital(Required)

Address of Hospital(Required)

City State / Province / Region

Are you nominating a colleague or submitting a self-nomination for a Chapter Award?(Required)

Self-nominations are permitted.

For which Chapter Award are you nominating a colleague or self-nominating?(Required)

Self-nominations are permitted.

Nominee Information

Name(Required)

First Middle Last Credentials

Email(Required)

Enter Email Confirm Email

Cell Phone(Required)

This number will not be shared with anyone outside of the Maryland ACEP Chapter Board or Chapter Executive Director.

Is the nominee a member of the Maryland ACEP Chapter?(Required)

Please submit a brief narrative (500 words or less) describing the nominee's achievements, contributions, and impact on emergency medicine.(Required)

Nominee Headshot(Required)

Please upload a headshot

Accepted file types: jpg, jpeg, gif, Max. file size: 50 MB.

Questions, Comments, and Concerns

Please use this section to provide any additional information relevant to your interest in the Chapter Award Nomination process (if necessary).