{"id":921,"date":"2025-02-25T16:14:19","date_gmt":"2025-02-25T16:14:19","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dhcc\/healthcareapplicationpackage\/"},"modified":"2025-02-25T16:14:19","modified_gmt":"2025-02-25T16:14:19","slug":"healthcareapplicationpackage","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dhcc\/healthcareapplicationpackage\/","title":{"rendered":"healthcareapplicationpackage ~  Health Care Practitioner Application Package  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n\n\n  <br>\n\n\n  \n\n\n  <div class=\"container\" id=\"main_header\">\n\n\n    <!-- BEGIN readspeaker div -->\n\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dhcc\/healthcareapplicationpackage.html\" title=\"Listen to this page using ReadSpeaker\">\n\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n\n      <\/a>\n\n\n    <\/div>\n\n\n    <!-- END readspeaker div -->\n\n\n\n\n\n    \n\n\n    \n\n\n    \n\n\n    <header class=\"pull-left\">\n\n\n      <h1><!--[type=EDIT name=\"Page Title\"]--><!--[END]--><\/h1>\n\n\n    <\/header>\n\n\n  <\/div><br>\n\n\n \n\n\n  <div class=\"container\">\n\n\n    <div class=\"row\">\n\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n\n          <div class=\"panel sectionmenu_panel\">\n\n\n            <div class=\"panel-heading\">\n\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Health Care Commission Menu<\/strong><\/a><\/p>\n\n\n            <\/div>\n\n\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dhcc\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n    <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n    <li>\n      <a href=\"\/dhcc\/about.html\">About DHCC<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/contact.html\">Contact Information<\/a>\n    <\/li>\n  \n    <li>\n      <a href=\"\/dhcc\/sections.html\">Sections &#038; Programs<\/a>\n    <\/li>\n  <\/ul><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n    <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">  \n    <li>\n      <a href=\"\/dhcc\/sim.html\">Delaware State Innovation Models (SIM) Initiative<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/dchi.html\">Delaware Center for Health Innovation (DCHI)<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/dhin.html\">Delaware Health Information Network (DHIN)<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/hrb\/dhrbhome.html\">Delaware Health Resources Board (DHRB)<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/dider.html\">Delaware Institute for Dental Education and Research (DIDER)<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/dimer.html\">Delaware Institute for Medical Education and Research (DIMER)<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/slrp.html\">State Loan Repayment Program (SLRP)<\/a>\n    <\/li>\n    <li>\n      <a href=\"https:\/\/www.choosehealthde.com\/\">Choose Health Delaware<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dhcc\/endoflife.html\">End-of-Life Workgroup<\/a>\n    <\/li>\n  <\/ul><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n    <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n    <li>\n      <a href=\"\/main\/contacts.htm\">Division Contact Information<\/a>\n    <\/li>\n    <li>\n      <a href=\"https:\/\/publicmeetings.delaware.gov\/\">State Calendar-Meeting Agendas &#038; Minutes<\/a>\n    <\/li>\n    \n  <\/ul><\/li>\n<!--    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n  <ul id=\"SocialMenu\">\n    <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" title=\"Division of Public Health Facebook Page\" target=\"_blank\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n    <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" title=\"Delaware Health and Social Services Twitter Account\" target=\"_blank\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n    <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n    <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n    <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n    <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n    <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n    <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> \n  <\/ul>\n<\/li>  -->\n<\/ul>\n\n\n\n\n              <\/div>\n\n\n            <\/div>\n\n\n          <\/div>\n\n\n        <\/div><br>\n\n\n      <\/div>\n\n\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n\n  <!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<table class=\"table table-condensed table-border table-hover\">\n\n\n\n\n\n\n  <tbody><tr class=\"info\">\n\n\n\n\n\n\n    <td class=\"b\">\n\n\n\n\n\n\n      Health Care Practitioner Application Package\n\n\n\n\n\n\n    <\/td>\n\n\n\n\n\n\n  <\/tr>\n\n\n\n\n\n\n  <tr>\n\n\n\n\n\n\n    <td>\n\n\n\n\n\n\n      Applicants: Please read the <a href=\"\/wp-content\/uploads\/sites\/4\/dhcc\/pdf\/slprprogramrepaymentguidelinemanual.pdf\">State Loan Repayment Program (SLRP) Program\n\n\n\n\n\n\n      Guidance Manual<\/a> in its entirety prior to proceeding to the health professionals&#8217; application. This guidance and the state loan\n\n\n\n\n\n\n      repayment website provide the details, eligibility criteria and qualifying regulations that govern Delaware&#8217;s program. Applicants\n\n\n\n\n\n\n      must have a complete understanding of their commitment to serve as a SLRP recipient within an approved practice site in a health\n\n\n\n\n\n\n      professional shortage area.<br>\n\n\n\n\n\n\n      <br>\n\n\n\n\n\n\n      All required information must be completed and required documentation must be uploaded before an application can be deemed\n\n\n\n\n\n\n      complete.<br>\n\n\n\n\n\n\n      <br>\n\n\n\n\n\n\n      Once the applications &#8211; Part A through Part C &#8211; have been filled out completely, please submit your application in one of three ways:\n\n\n\n\n\n\n      1) Mail the signed and completed original application containing all of the requested information and documentation; 2) Email the\n\n\n\n\n\n\n      application; or 3) Fax the application<br>\n\n\n\n\n\n\n      <p>\n\n\n\n\n\n\n        <strong>Note:<\/strong> Part C, page 3, requires original signature in blue ink AND notary seal. The original document must be\n\n\n\n\n\n\n        mailed or hand-delivered to the Delaware Health Care Commission office.\n\n\n\n\n\n\n      <\/p><br>\n\n\n\n\n\n\n      <strong>Mail:<\/strong> Delaware Health Care Commission<br>\n\n\n\n\n\n\n      Margaret O&#8217;Neil Building<br>\n\n\n\n\n\n\n      410 Federal Street, Suite 7<br>\n\n\n\n\n\n\n      Dover, DE 19901<br>\n\n\n\n\n\n\n      <br>\n\n\n\n\n\n\n      <br>\n\n\n\n\n\n\n      <strong>Email\/PDF scan:<\/strong> dhcc@delaware.gov<br>\n\n\n\n\n\n\n      <br>\n\n\n\n\n\n\n      <strong>Fax to:<\/strong> (302) 739-6927\n\n\n\n\n\n\n      <p>\n\n\n\n\n\n\n        To obtain a copy of the online application (Word fillable form) for the Delaware State Loan Repayment Program, please visit\n\n\n\n\n\n\n      <\/p>\n\n\n\n\n\n\n      <ul>\n\n\n\n\n\n\n        <li>\n\n\n\n\n\n\n          <a href=\"\/wp-content\/uploads\/sites\/4\/dhcc\/doc\/partbhealth.docx\">Practitioner\/Clinician Application (Part B)<\/a>\n\n\n\n\n\n\n        <\/li>\n\n\n\n\n\n\n        <li>\n\n\n\n\n\n\n          <a href=\"\/wp-content\/uploads\/sites\/4\/dhcc\/doc\/partcloan.docx\">Practitioner\/Loan Information (Part C)<\/a>\n\n\n\n\n\n\n        <\/li>\n\n\n\n\n\n\n      <\/ul>\n\n\n\n\n\n\n    <\/td>\n\n\n\n\n\n\n  <\/tr>\n\n\n\n\n\n\n<\/tbody><\/table>  <!--[END]-->\n\n\n  \n\n\n      <\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Health Care Commission Menu Home About About DHCC Contact Information Sections &#038; Programs Services Delaware State Innovation Models (SIM) Initiative Delaware Center for Health Innovation (DCHI) Delaware Health Information Network (DHIN) Delaware Health Resources Board (DHRB) Delaware Institute for Dental Education and Research (DIDER) Delaware Institute for Medical Education and Research (DIMER) State Loan [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-921","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dhcc\/wp-json\/wp\/v2\/pages\/921","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dhcc\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dhcc\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dhcc\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dhcc\/wp-json\/wp\/v2\/comments?post=921"}],"version-history":[{"count":0,"href":"https:\/\/dhss.delaware.gov\/dhcc\/wp-json\/wp\/v2\/pages\/921\/revisions"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dhcc\/wp-json\/wp\/v2\/media?parent=921"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}