2A Table 2A

Nurse Anesthetist Traineeship (NAT) Program

Table 2A NAT Forms

NAT Forms

OMB: 0915-0374

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Table 2A - NAT: Graduate Data - Rural, Underserved, or Public Health (MM/DD/20XX-MM/DD/20XX)


Meeting the Statutory Funding Preference (SFP) is contingent on meeting the Statutory Funding Preference High Rate.


Meeting the Special Consideration (SPC) is contingent on meeting the Special Consideration High Rate.


Complete Table 2A, as appropriate, providing data on the number of Nurse Anesthesia graduates who completed degree requirements between MM/DD/20XX-MM/DD/20XX and are employed at clinical practice sites substantially benefiting rural or underserved populations, or in State or local health departments. Instructions for completing Table 2A are below.



Practice Settings


No. of Graduates


Community Health Centers




Migrant Health Centers




Health Care for the Homeless Grantees




National Health Service Corps Sites




Indian Health Service Sites/Tribal Health Sites




Federally Qualified Health Centers




State or Local Health Departments




Ambulatory Practice Sites Designated by State Governors




Health Professional Shortage Areas (HPSAs)




Rural Populations / Settings



Underserved Populations / Settings



    1. Total Number of Graduates employed in these Settings (from MM/DD/20XX – MM/DD/20XX)




    1. Total Number of Graduates (from MM/DD/20XX – MM/DD/20XX)




    1. Percentage of Graduates Employed in these Settings (SFP)

(Number 1 divided by Number 2)




    1. Percentage of Graduates Employed in HPSAs (SPC)

(Total Number of HPSAs from row above divided by Total Number of Graduates from MM/DD/20XX-MM/DD/20XX)


OMB NO.: 0915-XXXX EXP. DATE: MM/DD/20XX

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