Apply to Become an NHSC Site

This section assesses your site’s eligibility to participate in the program. If your site does not pass the prescreening questionnaire, you will not be able to continue. Refer to the “Eligibility Requirements and Qualification Factors” section in the NHSC Site Reference Guide (PDF - 676 KB) to ensure your site meets the appropriate requirements.

This section asks for general information, such as your site name, address, website, and unique identifiers.

This section identifies similar or potential duplicate sites that already have a BHW site record. If your site applied previously, use the same site record. Do not create a duplicate. If you need to be added as a Point of Contact (POC) to an old record, contact your NHSC state or territorial lead.

In this section, you will select the comprehensive primary medical, mental/behavioral health, and/or dental health care services provided on-site. In addition, you will submit data regarding the site staffing full-time equivalents. The information collected in this section is part of the NHSC Site Data Tables (PDF - 236 KB).

If your site provides behavioral health and/or substance use disorder services on-site, you must provide the following for site approval:

• A completed Comprehensive Behavioral Health Services Checklist (PDF - 177 KB). During application cycles, you will directly enter this data in the Behavioral Health section of the application.
• Documentation demonstrating the provision of core and non-core comprehensive behavioral health services.

Refer to the "Comprehensive Primary Behavioral Health Services" section of the NHSC Site Reference Guide to ensure your site is eligible.

This section requests data regarding accepted insurance, payment types, patients, and the sliding fee discount program. The information collected in this section is part of the NHSC Site Data Tables (PDF - 236 KB). You must upload all required documentation. Otherwise, the system will not let you submit your application.

This section asks questions regarding your site's telehealth services. Sites that provide 100 percent telehealth services do not qualify for the NHSC.

In this section, you must list at least two POCs (except for solo private practices). Only POCs who own, oversee, or manage a significant portion of your organization and can answer questions about policies and operating procedures can submit your site application. If approved, the POC information will be visible to the public on the Health Workforce Connector.

In this section, you must verify the appropriate HPSA score using the HPSA Find tool on data.hrsa.gov. The NHSC and primary care office will verify this information and, if needed, add all missing HPSA IDs during the application review process.

In this section, you must upload all remaining supporting documents.

Site types and document exemptions/requirements

The following information lists the various required documents for NHSC site approval by site type and shows when each document may be required.

Sliding fee discount program documents

Clinician recruitment and retention plan

Proof of access to comprehensive care

Behavioral health services checklist and supporting documentation

Substance use disorder (SUD)/medications for opioid use disorder (MOUD) documentation

Data reporting

*Other: These sites need to provide the NHSC with proof that no one is charged or billed for services, and people are not denied service because they are unable to pay.

**All other site types: critical access hospitals, state or local health departments, community outpatient facilities, private practices, school-based clinics, mobile units, office-based opioid treatment facilities, and non-opioid outpatient substance use disorder treatment facilities.

In the last section of the online NHSC Site Application, a POC with express authority must review and sign the NHSC Site Agreement (PDF - 291 KB) certifying compliance with the program.

Use the Site Points of Contact User Guide (PDF - 5 MB) to assist you with your application.