WebEnter the first and last name of a contact person who is authorized to submit the application and who can be contacted if HRSA has additional questions or needs to follow up. The … WebFORM 5B: SERVICE SITES FOR HRSA USE ONLY Application Tracking Number Grant Number Site Qualification Criteria 1. Is the site an "admin-only" site? [_] Yes [_] No If ‘No’, a.a. Are/will health center encounters generated by documenting in the patients’ records face-to-face contacts between patients and providers? [_] Yes [_] No [_] Not ...
Form 3: Income Analysis - Bureau of Primary Health Care - HRSA
WebWhen you apply, you need to fill out an SF-424 application form. We created a guide for each of these forms. SF-424 Application Guide (PDF - 668 KB) SF-424 Two-Tier … WebInstructions for Form 5B: Service Sites Background: Sites are one of five elements that comprise the scope of project, as described in PIN 2008-01. 1 Specifically, the scope of … traffic cameras soldotna ak
Form 5B: Service Sites - Health Resources and Services …
WebForm 5A: Services Provided delivered in a manner that will support the provision of care to the number of patients listed on Form 1A: General Information Worksheet. HRSA … Web2 jun. 2024 · change in scope requests to HRSA to ensure that your scope of project accurately reflects any changes needed to implement activities. This includes: (1) Form 5A: Services Provided, (2) Form 5B: Service Sites, and (3) Form 5C: Other Activities/Locations. For additional information, review the technical assistance materials on the thesaurus for suggest