Find out how and when to apply for Health Center Program LAL ID.
Review key information
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Who can apply
You must:
- Be a public or nonprofit entity
- Serve areas or populations that lack access to primary care
Review the application instructions for the full list of criteria.
How to apply
Before you apply
Do the following:
- Review the Health Center Program Compliance Manual
- Comply with all Health Center Program requirements
- Register in the System for Award Management (SAM)
- Review the Application Instructions (PDF - 667 KB)
Apply any time
Fill out your application. You have 90 days to complete your application in the HRSA Electronic Handbooks (EHBs).
Resources for your application
Application aid
Attachments and forms
- Attachment 2: Instructions for Service Area Map and Table. Use Health Center Program GeoCare Navigator to create your map and table.
- Form 1A: General Information Worksheet (PDF - 211 KB)
- Form 1C: Documents on File (PDF - 34 KB)
- Form 2: Staffing Profile (PDF - 189 KB)
- Form 3: Income Analysis (PDF - 169 KB)
- Form 3A: Look-Alike Budget Information (PDF - 85 KB)
- Form 4: Community Characteristics (PDF)
- Form 5A: Services Provided (PDF - 195 KB)
- Form 5B: Service Sites (PDF - 171 KB)
- Form 5C: Other Activities/Locations (PDF - 117 KB)
- Form 6A: Current Board Member Characteristics (PDF)
- Form 6B: Request for Waiver of Board Member Requirement (PDF - 157 KB)
- Form 8: Health Center Agreements (PDF - 93 KB)
- Form 12: Organization Contacts (PDF - 131 KB)
Find technical assistance
- Health Center Program Site Visit Protocol
- Strategic Partnerships
- What Is Shortage Designation?
- Contact Your State/Territorial Primary Care Office
Contact us
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Add 'BPHCAnswers@hrsa.gov' to your address book to make sure you receive our reply email.
If you have a question about: | You can reach us at: |
---|---|
Program |
Under Look-Alike Designation, select Initial Designation (LAL-ID) |
EHBs |
Under Technical Support, select EHBs Tasks/EHBs Technical Issues Call 877-464-4772 (select option 1) 8 a.m. – 8 p.m. ET, Monday – Friday (except federal holidays) |
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