Nurse Faculty Loan Program Forms

The NFLP – Program Specific Data Form is a required electronic attachment within the NFLP application materials. The data provided in the form is essential for the formula-based criteria used to determine the award amount to the applicant schools. The form will collect application-related data from applicants such as the amount requested, number of students to be funded, tuition information, and projected unused loan fund balance. The NFLP-Annual Performance Report (APR) Financial Data Form is an online form that exists in the HRSA Electronic Handbooks (EHBs) Performance Report module. The NFLP-APR Financial Data Form collects outcome and financial data to capture the NFLP loan fund account activity related to financial receivables, disbursements, and borrower account data related to employment status, loan cancellation, loan repayment and collections. Participating schools will provide HHS with current and cumulative information on: (1) NFLP loan funds received, (2) number and amount of NFLP loans made, (3) number and amount of loans cancelled, (4) number and amount of loans in repayment, (5) loan default rate percent, (6) number of NFLP graduates employed as nurse faculty, and (7) other related loan fund costs and activities. The NFLP Due-Diligence Form is a required form to be completed and submitted electronically by NFLP award recipients. This form indicates that due diligence has been exercised in the cancellation of all or any remaining NFLP loan for NFLP borrowers in the event of permanent/total disability or death, or the write-off of all or any remaining payment of the NFLP loan as uncollectible/bad debt. The data provided on the form will verify the due diligence process the institution used for NFLP loan cancellations or uncollectible debt write-offs. Data collected on the due-diligence form is essential for HRSA to effectively monitor performance outcomes and verify the accuracy of the number and amount of NFLP loan funds cancelled and written off that is reported by NFLP award recipients during the Annual Performance Reporting period. The form will collect the student borrower’s unique ID, amount of loan funds cancelled/written off (principal plus interest), reason for cancellation/write-off, and institutional certification/due diligence process utilized.

The latest form for Nurse Faculty Loan Program Forms expires 2029-07-31 and can be found here.

Nurse Faculty Loan Program Forms- Program Specific Data Form

Federal Enterprise Architecture: Health - Health Care Services

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