Application for Free Clinics to Sponsor Individuals for Deemed PHS Employment with Liability Protections Under the FTCA

Applications for Deemed Public Health Service Employment with Liability Protections Under the FTCA for Health Centers, Deemed Health Center Volunteers, and Free Clinic Sponsored Individuals

OMB: 0906-0090

IC ID: 266935

Documents and Forms

Document Name Document Type
Form 4 Application for Free Clinics to Sponsor Individuals for Deemed PHS Employment with Liability Protections Under the FTCA Form and Instruction
4 Application for Free Clinics to Sponsor Individuals for Deemed PHS Employment with Liability Protections Under the FTCA FTCA Free Clinic Application Tool.pdf Form and Instruction