2B Table 2B

Nurse Anesthetist Traineeship (NAT) Program

Table 2B NAT forms

NAT Forms

OMB: 0915-0374

Document [docx]
Download: docx | pdf

Table 2B - NAT: Graduates Supported by Traineeship Data - Rural, Underserved, or

Public Health (MM/DD/20XX-MM/DD/20XX)


Complete Table 2B, as appropriate, providing data on the number of Nurse Anesthesia graduates supported by traineeships that 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 2B are below.



Practice Settings


No. of Graduates Supported


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. 1. Total Number of Graduates Supported By Traineeships Employed in these Settings (from MM/DD/20XX – MM/DD/20XX)




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




  1. 3. Percentage of Graduates Supported by Traineeships Employed in these Settings

(Number 1 divided by Number 2)



4. Percentage of Graduates Supported by Traineeships Employed in HPSAs (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/20XXXX


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGLipton
File Modified0000-00-00
File Created2021-01-28

© 2024 OMB.report | Privacy Policy