Physician of the Quarter
  1. Do you know a Good Samaritan physician who should be recognized for his/her outstanding service and support to his/her patients? Has his/her compassion and comfort touched you or someone you know? Good Samaritan would like you to nominate a doctor affiliated with the hospital who encompasses these qualities for its Physician of the Quarter program. Throughout the year, the hospital will recognize its physicians who have gone above and beyond to help his or her patients. Good Sam will be accepting letters of nominations no longer than 300 words, from patients wishing to nominate their physicians. Please include specific examples of how they exceed their normal duties. The patient selected and his/her doctor will be invited to a special ceremony and have their story displayed in Good News From Good Sam and on the hospital’s website. Winning physicians will receive a certificate and the nominating patient will receive $100. You can use the form below to nominate your Physician of the Quarter.
  2. Physician's Name(*)
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  3. Contact Number of your Physician(*)
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  4. Nominate a Physician (please limit entry to 300 words)(*)
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  5. Name(*)
    Please provide us with your full name.
  6. Address(*)
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  7. City(*)
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  8. State:
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  9. Zip(*)
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  10. E-mail:(*)
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  11. Telephone(*)
    xxx-xxx-xxxx
  12. Please enter the 4 letter code as it appears in the box
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  13. Nominations can also be mailed to: Good Samaritan Hospital Medical Center Office of Public & External Affairs Physician of the Quarter 1000 Montauk Highway West Islip, NY 11795 Please remember to limit your entry to 300 words. Thank you & Good luck!

1000 Montauk Highway
West Islip, NY 11795

phone 631.376.4444

A Magnet® Designated Hospital