The NHSC and NURSE Corps Interest Capture Form

The NHSC and Nurse Corps Interest Capture Form, which can be accessed on the HRSA website at https://bhw.hrsa.gov/about-us/ask-question, is an optional form that a health profession student, licensed clinician, faculty member, clinical site administrator, or other interested individual can complete and submit to HRSA online. The purpose of the form is to allow individuals to voluntarily ask questions about the NHSC and/or Nurse Corps Scholarship and Loan Repayment Programs, and to provide their contact information so that HRSA may provide them with direct responses, periodic program updates, and other general information via e-mail. Completed forms will contain information such as the names and roles of the individual(s), their phone number(s) and email address(es), and the HRSA program(s) in which they are interested or about which they have questions.

The latest form for The NHSC and NURSE Corps Interest Capture Form expires 2029-04-30 and is listed under ICR 202512-0915-002.