Board Proxy Med

Proxy for Board Members to use if they are unable to attend a scheduled meeting
Board Member Name:
First Last
Gives Proxy to:
First Last
Medical Board meeting (check all that apply)*
- Medical Board Meeting - Feb 25, 2021, at 12 PM in ZOOM conference
Consent*
In my absence, I hereby grant my proxy for this meeting to the above fellow board member for all voting purposes.
Date
MM slash DD slash YYYY

Proxy for Board Members to use if they are unable to attend a scheduled meeting