OMB control number
National Health Service Corps Scholar/Students to Service Travel Request Worksheet
OMB 0906-0087 · HHS/HRSA.
OMB 0906-0087
Clinicians participating in the HRSA National Health Service Corps (NHSC) Scholarship Program and the Students to Service (S2S) Loan Repayment Program use the online Travel Request Worksheet to receive travel funds from the Federal Government to visit eligible NHSC sites to which they may be assigned in accordance with the Public Health Service Act (PHSA), section 331(c)(1).
The latest form for National Health Service Corps Scholar/Students to Service Travel Request Worksheet expires 2027-04-30 and is listed under ICR 202404-0906-003.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 1 NHSC Travel Request Worksheet | Form |
| Supporting Statement - NHSC Travel Request Worksheet - Final Draft v.2.docx | Supporting Statement A |
 NHSC Travel Request Worksheet |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202404-0906-003 | Revision of a currently approved collection | 2024-04-15 | Approved without change |