Federal Tort Claims Act (FTCA) Program Deeming Sponsorship Applications for Free Clinics

OMB 0915-0293

OMB 0915-0293

Deemed status for FTCA medical malpractice coverage requires HRSA approval of an application for deeming of certain eligible individuals from a sponsoring Free Clinic. The FTCA Program Deeming Sponsorship Application for Free Clinics is an electronic application submitted to HRSA through the Electronic Handbooks as part of the process of deeming qualified health care professionals, board members, officers, and individual contractors.

The latest form for Federal Tort Claims Act (FTCA) Program Deeming Sponsorship Applications for Free Clinics expires 2024-01-31 and can be found here.

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