CIHR-IHSPR Article of the Year Award: Nomination Form

Section A

Nominator

• Surname
• First Name
• Position
• Institution or Organization
• Address
• Telephone
• Fax
• Email address

Section B

Lead Author of Nominated Article (if different from nominator)

• Surname
• First Name
• Position
• Institution or Organization
• Address
• Telephone
• Fax
• Email address

Section C

Full Citation for Nominated Article

Section D

Award Category of Nominated Article (please check one)

• Research that has had a clear impact or potential impact on policy or practice
• Research that breaks ground in the way that health services and policy research is conducted

Section E

Please explain how the nominated article has contributed to the advancement of the field of health services and policy research in Canada (maximum 300 words).

Section F

Attachments:
Please submit this application form and an electronic or hard copy of the nominated article by mail or email, on or before February 3, 2012 to:

Liz Drake
Associate, Strategic Initiatives
CIHR Corporate Headquarters
Room 97, 160 Elgin Street
Address locator: 4809A
Ottawa, Ontario K1A 0W9
Email: Elizabeth.Drake@cihr-irsc.gc.ca