Required Documentation

NHSC Sites

Compile the required documentation to submit with your application:

• Sliding discount fee schedule (Not required for Tribal facilities that provide free services to members)
• Proof of practice (business license, articles of incorporation, commercial lease agreement, state facilities license, accreditation certificate from the Joint Commission, or accreditation by the Association of Ambulatory Health Care)
• Proof of appropriate referral for ancillary, specialty, and inpatient care (MOU, letters from specialty care facilities or providers, proof of hospital admitting privileges)
• Provider Recruitment and Retention Plan