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Advanced Practice Providers Award Nomination Form

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Please complete the form below to nominate an Advanced Practice Provider for the 2026 APP of the Year. Recipients must meet the following criteria to be eligible:

  • Demonstrates strong leadership skills in urology while advancing the APP role and enhancing APP visibility both regionally and nationally.
  • Delivers outstanding patient care by driving change through the implementation of evidence-based practices and innovative practice models.
  • Significantly contributes to the APP program at their respective Section/Society meeting and/or shows leadership in coordinating other APP activities/initiatives.
Contact Information for Nominee
Contact Information for Individual Making Nomination
References

Please upload the following documents for reference:

  1. Letter of Recommendation – Please attach a letter of support (pdf files ONLY) that addresses the following:
    • Leadership in urology and advancement of the APP role
    • Delivery of outstanding patient care through evidence-based and innovative practices
    • Contributions to APP programming or leadership within a Section/society or other APP initiatives
  2. Curriculum Vitae (CV) – Please upload your nominees most recent CV (PDF files ONLY Note: The filename should not contain any punctuation, special or foreign characters.)

If you are unable to upload your documents please email them as attachments to appmembership@AUAnet.org.

Allowed file type: PDF The maximum total file size for all documents should be less than 4MB.Total file size submissions exceeding 4MB may result in an error and delays with processing your application.

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