VA Health Professional Scholarship Programs (HPSP, VIOMPSP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 10-0491k VA Scholarship Offer Response	Form	Modified	Available
Form VA Form 10-0491j Request for Deferment	Form	Modified	Available
Form VA Form 10-0491i Notice of Change (NOC)	Form	Modified	Available
Form VA Form 10-0491h Notice of Expected Graduation	Form	Modified	Available
Form VA Form 10-0491g Application	Form and Instruction	Modified	Available
Form VA Form 10-0491e Evaluation and Recommendation Form	Form	Modified	Available
Form VA Form 10-0491d Obligated Service	Form	Modified	Available
Form VA Form 10-0491c Annual VA Employment or Deferment Verification	Form	Modified	Available
Form VA form 10-0491 Academic Verification	Form	Modified	Available
30-day FRN_2900-0793_VA Health Prof Scholarship Prog - HPSP VIOMPSP_pub 08052026.pdf	Supplementary Document	Uploaded 2026-08-05	Available
2900-0793_Response to 60-day FRN comment_VA Health Prof Scholarship Programs_July 2026.pdf	Supplementary Document	Uploaded 2026-07-23	Available
VA-2026-VACO-0001-0244.pdf	Public Comments	Uploaded 2026-07-14	Available
60-day FRN_2900-0793_VA Health Prof Scholarship Prog - HPSP VIOMPSP_pub 05152026.pdf	Supplementary Document	Uploaded 2026-05-20	Available
2900-0793_SSA_VA Health Prof Scholarship Prog - HPSP VIOMPSP_updated Aug 2026.docx	Supporting Statement A	Uploaded 2026-08-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	VA Scholarship Offer Response
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Request for Deferment
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Notice of Change (NOC)
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Notice of Expected Graduation
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form and Instruction	Modified	Application
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Evaluation and Recommendation Form
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Obligated Service
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Annual VA Employment or Deferment Verification
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Academic Verification

ICR Details

OMB Control No: 2900-0793	ICR Reference No: 202603-2900-015
Status: Received in OIRA	Previous ICR Reference No: 202212-2900-003
Agency/Subagency: VA	Agency Tracking No: VHA-2900-0793
Title: VA Health Professional Scholarship Programs (HPSP, VIOMPSP)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/06/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2,050	0
Time Burden (Hours)	8,017	0
Cost Burden (Dollars)	0	0

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Abstract: The Department of Veterans Affairs (VA) Health Professional Scholarship Program (HPSP) and the VA Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) were authorized under Public Law 111-163 on May 5, 2010, and extended through December 31, 2033, by Section 301 of P.L. 115-182, VA Mission Act of 2018. These programs help address health care workforce needs and allow VA to provide services to the public by awarding scholarships to VA employees, and non-VA employees who will be required to become VA employees, in the professions for which they were educated under these programs. This information collection is necessary for VA to determine an applicant's eligibility to receive a scholarship award and compliance with program requirements. The Educational Assistance for Certain Former Members of the Armed Forces (EACFMAF) Program and the Veterans Healing Veterans Medical Access and Education Scholarship Program (VHVMAESP), which were previously included in this collection, have been removed because these were pilot programs that have ended and will not be renewed by VA. Two forms associated with these pilot programs also have been removed form the collection.

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Authorizing Statute(s): PL: Pub.L. 111 - 163 603 Name of Law: Reauthorization of Health Professionals Educational Assistance and Scholarship Program
   PL: Pub.L. 115 - 182 301 Name of Law: The VA Mission Act of 2018
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 28105	05/15/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 50607	08/05/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	VA form 10-0491, VA Form 10-0491c, VA Form 10-0491d, VA Form 10-0491e, VA Form 10-0491g, VA Form 10-0491h, VA Form 10-0491i, VA Form 10-0491j, VA Form 10-0491k	Academic Verification ,   Annual VA Employment or Deferment Verification ,   Obligated Service ,   Evaluation and Recommendation Form ,   Application ,   Notice of Expected Graduation ,   Notice of Change (NOC) ,   Request for Deferment ,   VA Scholarship Offer Response

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,050	0	0	2,050	0	0
Annual Time Burden (Hours)	8,017	0	0	8,017	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There is an increase in burden hours because, although two pilot programs are no longer included in this collection, there is an increase in estimated HPSP applicants based upon program data.

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Annual Cost to Federal Government: $13,174,028

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/06/2026

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