Submit Look-Alike Annual Certification (LAL AC)

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• How to submit
• Resources for your submission
• Technical assistance
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How to submit

When it’s time for you to submit:

1. Your points of contact will receive an email from EHBs.
   • We send the email 150 calendar days prior to the end of the current certification period.
   • Complete the BPHC Contact Form if your contacts do not receive an email to submit.
2. Your Authorizing Official (AO) must submit through EHBs. You have 60 calendar days to complete and submit required information.

What you’ll report

• Progress you’ve made since you submitted the last time you applied (Renewal Designation [RD] or AC) 
• Expected progress for the rest of the current certification period
• Projected changes for the upcoming certification period

EHBs access and deadline schedule

Submit by the deadline. If you do not, you risk the end of your LAL designation and its benefits.

*EHBs auto-generate access and deadline dates. Please work within these dates to submit.

Request technical assistance prior to the deadline if the deadline falls on a weekend or holiday.

Find resources for your submission

Submission aid

FY25 Technical Assistance (TA) Briefing | FY25 TA Briefing slides (PDF - 988 KB)

Attachments and program specific forms

• Form 1C (PDF - 145 KB)
• Form 3: Income Analysis (PDF - 205 KB)
• Form 3A: LAL AC Budget Information (PDF - 158 KB)
• LAL AC Budget Narrative Sample

Find technical assistance

• Uniform Data System (UDS) Training and Technical Assistance
• Health Center Program Compliance Manual

Contact us