S2S LRP - Letters of Recommendation

OMB Number: 0915-0146
Expiration Date: XX/XX/20XX
Bureau of Health Workforce
U.S. Department of Health and Human Services
Health Resources and Services Administration

National Health Service Corps Students to Service Loan Repayment Program
Additional Letter of Recommendation – Instructions
This letter should be from individuals who are familiar with the applicant and his/her academic, professional,
community, and/or civic activities, particularly those related to primary care and underserved communities. A
recommender can be a current or former employer, community leader, colleague, or anyone who has
knowledge of the applicant’s interest and commitment to a career in primary care and service to underserved
populations and communities.
All recommendations must be submitted by the recommender through the application portal. To complete
and submit the letter of recommendation, please click on the link you received via email and submit the
recommendation. The letter must have a handwritten signature and/or be on letterhead from the
recommender’s organization/institution, if appropriate, and include the following:
1) Applicant’s first, middle initial and last name;
2) Last four digits of the applicant’s Social Security Number (if known);
3) Applicant’s anticipated specialty (if known);
4) Recommender’s Name (printed) and Title;
5) Recommender’s Address (unless already on letterhead);
6) Handwritten Signature;
7) A description of the recommender’s relationship to the applicant and length of time he/she has known
the applicant; and
8) A discussion of the following items:
a. The applicant’s academic, professional, community, and/or civic achievements;
b. The applicant’s ability to work and communicate effectively with patients and colleagues;
c. An assessment of the applicant’s particular characteristics, interests, and motivations to serve
populations in underserved communities; and
d. An assessment of the applicant’s work experiences, course work, special projects, research, or
other activities that demonstrate an interest in and commitment to serving underserved
populations and communities.
Public Burden Statement: The purpose of the NHSC SP, NHSC S2S LRP, and the NHHSP is to provide scholarships or loan repayment to qualified students who
are pursuing primary care health professions education and training. In return, students agree to provide primary health care services at approved facilities
located in designated Health Professional Shortage Areas (HPSAs) once they are fully trained and licensed health professionals. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control
number for this information collection is 0915-0146 and it is valid until XX/XX/202X. This information collection is required to obtain or retain a benefit (NHSC
SP: Section 338A of the PHS Act and Section 338C-H of PHS Act; NHSC S2S LRP: Section 338B of the PHS Act and Section 331(i) of the PHS Act; NHHSP: The
Native Hawaiian Health Care Improvement Act of 1992, as amended [42 U.S.C. 11709]. Public reporting burden for this collection of information is estimated
to average xx hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or paperwork@hrsa.gov.