U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Required Documents


The following documentation MUST accompany your completed application:

  • License to Practice -- Provide a copy of full and unrestricted state license
  • Employment Verification - Provide IHS, Tribal, or Urban employment verification. IHS employees should submit either Commissioned Corps Orders or Standard Form 50B (SF-50B). Tribal and Urban health employees should submit employment verification information on Tribal or Urban letterhead.

Special Circumstances

  • American Indian or Alaska Native — Form BIA-4432 (Verification of Indian Preference for Employment in the Bureau of Indian Affairs and the Indian Health Service)
  • IHS Health Professions (Section 104) Scholarship Recipient — Completion Letter, if applicable, P.L. 94-437

You may fax these documents to the Loan Repayment Office at (301) 443-4815. If you have an electronic (PDF) copy of your employment verification, you will have the opportunity to upload it when you fill out your application.

If you have your required documents ready, you may begin your application.