Teaching Health Center Planning and Development Program

Health Resources and Services Administration
Academic Year: 2023-2024

Bureau of Health Workforce
OMB Number: 0906-0086

Annual Performance Report
OMB Expiration Date: 03/31/2027

IND-GEN: Individual Characteristics

IND-GEN - Setup

Warning
If you have trainees who began their residency/fellowship in June/July 2022 (last summer), you will need to complete the INDGEN form and all other forms. Do not report on trainees who began their residency/fellowship in June/July 2023.

Do you have either a) new trainees OR b) updates to provide for trainees from a previous reporting period?

Yes (complete IND-GEN) No (click Save and Validate button to proceed to the next form)

Figure 1. IND-GEN - Setup

Do you have either a) new trainees OR b) updates to provide for trainees from a previous reporting period?:

Warning
If you have used the INDGEN form before, this answer is pre-selected ‘Yes’ for you. You do not need to answer this question again. Please move ahead to the INDGEN form by using the form list located on the left side of your screen.

Warning
If you are unable to enter data into the INDGEN form, edit prior records, or see drop-down menus despite the question above being answered ‘Yes’, you have a browser compatibility problem. Please refer to the Getting Started-Browser Settings page at the beginning of this manual.

Warning
Gray fields in prior records cannot be edited.

Warning
Prior records cannot be deleted.

IND-GEN - Selecting Type of Training Program

Type of Training Program
(1)

Figure 2. IND-GEN - Selecting Type of Training Program

Type of Training Program: Select each individual's training program by clicking on the drop-down menu under the column labeled "Type of Training Program" and choosing one of the available options.

Note
The options available under "Type of Training Program" will prepopulate with information entered and saved in the Training Program Setup Form.

Note
This program is no longer able to select "Other" for Type of Training Program. Also, prior records for faculty who had a Type of Training Program of "Other" were deleted.

Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted.

Example: The School of Medicine saved two (2) entries in the Training Program Setup form to reflect the type of programs supported by the grant. Under "Type of Training Program" the School of Medicine would see the following options:

Residency program | Internal Medicine

Residency program | Family Medicine

IND-GEN - Entering Trainee Unique ID

Trainee Unique ID
(2) Block 1

Figure 3. IND-GEN - Entering Trainee Unique ID

Trainee Unique ID: Enter a seven (7) character alphanumeric unique identifier for each individual in the textbox in Column 2 (Block 1).

Warning
It is the responsibility of each grantee to generate each unique ID and keep a log of all unique IDs used, as these will be required to provide annual updates and 1-year follow-up data for each individual.

Note
This Block will prepopulate for prior records with data submitted in previous reporting periods.

IND-GEN - Entering NPI Number

NPI Number
(2a)

Figure 4. IND-GEN - Entering NPI Number

NPI Number: Enter the 10-digit National Provider Identifier (NPI) number for each individual in the textbox in Column 2a. To apply for an NPI number, go to: https://nppes.cms.hhs.gov.

Note
NPIs are required as of AY 2022-2023.

IND-GEN - Selecting Individual's Training or Awardee Category

Select Individual's Training or Awardee Category
(3) Block 2

Figure 5. IND-GEN - Selecting Individual's Training or Awardee Category

Select Individual's Training or Awardee Category: Select each individual's training category by clicking on the drop-down menu in Column 3 (Block 2) and choosing one of the following options.

Fellow
Resident

Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted.

IND-GEN - Selecting whether Individual is an IMG

Select Whether Individual is an International Medical Graduate (IMG)
(3a)

Figure 6. IND-GEN - Selecting whether Individual is an IMG

Select Whether Individual is an International Medical Graduate (IMG): Select whether each individuals is an International Medical Graduate (IMG) by clicking on the drop-down menu and choosing one of the following options:

IND-GEN - Selecting Individual's Enrollment/Employment Status

Select Individual's Enrollment / Employment Status
(4) Block 3

Figure 7. IND-GEN - Selecting Individual's Enrollment/Employment Status

Select Individual's Enrollment / Employment Status: Select each individual’s current enrollment status in the program by clicking on the drop-down menu in Column 4 (Block 3) and choosing one of the following options.

Full-time
Both Full-time and Part-time
Part-time
On leave of absence

IND-GEN - Selecting Individuals Gender

Select Individual's Gender(s)
(5a)

Figure 8. IND-GEN - Selecting Individuals Gender

Select Individual's Gender(s): Select the gender option(s) that apply to each individual by clicking on the drop-down menu under column 5a and choosing all that apply:

Female
Male
Transgender or non-binary or another gender
Not reported

Warning
The 'Not Reported' option may not be selected for prior records.

Warning
'Not Reported' cannot be selected in combination with any other options under column 5a.

IND-GEN - Entering Year of Birth

Enter Year of Birth
(6a)

Figure 9. IND-GEN - Entering Year of Birth

Enter Year of Birth: Enter each individual’s year of birth at the end of the current reporting period in the textbox in Column 6a.

1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Not Reported

Warning
The 'Not Reported' option may not be selected for prior records.

IND-GEN - Selecting Individual's Ethnicity

Select Individual's Ethnicity
(7) Block 6

Figure 10. IND-GEN - Selecting Individual's Ethnicity

Select Individual's Ethnicity: Select each individual’s ethnicity by clicking on the drop-down menu in Column 7 (Block 6) and choosing one of the following options:

Hispanic/Latino
Non-Hispanic/Non-Latino
Not Reported

Warning
The 'Not Reported' option may not be selected for prior records.

Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted.

IND-GEN - Selecting Individual's Race

Select Individual's Race
(8) Block 7

Figure 11. IND-GEN - Selecting Individual's Race

Select Individual's Race: Select each individual’s race by clicking on the drop-down menu in Column 8 (Block 7) and choosing all that apply from the available options. You may select more than one option for individuals of multiple races.

American Indian or Alaska Native
Asian
Black or African-American
Native Hawaiian or Other Pacific Islander
White
Not Reported

Warning
You may not select "Not Reported" in combination with any other option.

Warning
The 'Not Reported' option may not be selected for prior records.

Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted.

IND-GEN - Selecting if Individual is from a Rural Residential Background

Select Whether Individual is from a Rural Residential Background
(9) Block 8

Figure 12. IND-GEN - Selecting if Individual is from a Rural Residential Background

Select Whether Individual is from a Rural Residential Background: Select whether each individual is from a rural residential background by clicking on the drop-down menu in Column 9 (Block 8) and choosing one of the following options:

Yes
No
Not Reported

Warning
The 'Not Reported' option may not be selected for prior records.

Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted.

Reference
Refer to the glossary for a definition of rural setting.

IND-GEN - Selecting if Individual is from a Disadvantaged Background

Select Whether Individual is from a Disadvantaged Background
(10) Block 9

Figure 13. IND-GEN - Selecting if Individual is from a Disadvantaged Background

Select Whether Individual is from a Disadvantaged Background: Select whether each individual is from a disadvantaged background by clicking on the drop-down menu in Column 10 (Block 9) and choosing one of the following options:

Yes
No
Not Reported

Warning
The 'Not Reported' option may not selected for prior records.

Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted.

Reference
Refer to the glossary for a definition of disadvantaged background.

IND-GEN - Selecting Individual's Veteran Status

Select Individual's Veteran Status
(11) Block 10

Figure 14. IND-GEN - Selecting Individual's Veteran Status

Select Individual's Veteran Status: Select each individual's current veteran status by clicking on the drop-down menu in Column 11 (Block 10) and choosing one of the following options:

Active Duty Military
Individual is not a Veteran
National Guard
Reservist
Veteran - Prior Service
Veteran - Retired
Not Reported

Warning
The 'Not Reported' option may not be selected for prior records.

Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted.

Reference
Refer to the glossary for a definition of the various types of veteran statuses.

IND-GEN - Entering BHW-Funded Financial Award Information

Warning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully.

Select Whether Individual Received BHW Financial Award?	Enter Individual's Financial Award Amount (BHW funds only)	Enter Individual's Financial Award Amount (BHW funds only)	Enter Individual's Financial Award Amount (BHW funds only)	Enter Individual's Financial Award Amount (BHW funds only)
Select Whether Individual Received BHW Financial Award?	Stipend	Traineeship	Fellowship	Academic Year Total (Auto-Populates)
(12) Block 11	(13) Block 11	(14) Block 11	(20) Block 11	(21b) Block 11

Figure 15. IND-GEN - Entering BHW-Funded Financial Award Information

Select Whether Individual Received BHW Financial Award?: Select whether each individual received a BHW-funded financial award (i.e., salary and benefits) during the current reporting period by clicking on the drop-down menu in Column 12 (Block 11) and choosing one of the following options:

Enter Individual's Financial Award Amount (BHW funds only): Stipend:

If the individual is a resident, fellow, or faculty and received a BHW-funded financial award, enter the total amount of BHW dollars provided during the current reporting period in the textbox under Stipend. Total amount reported should account for all BHW dollars including those applied to salary, fringe benefits, travel expenses, conference expenses, tuition, fees, and reasonable living expenses, as allowed by federal statutes and regulations (do not report salary or benefits for faculty).
If the individual did not receive a financial award, select "No" in Column 12 (Block 11) and enter "0" in Stipend columns where no money was disbursed.

Enter Individual's Financial Award Amount (BHW funds only): Traineeship:

If the individual is a resident, fellow, or faculty and received a BHW-funded financial award, enter the total amount of BHW dollars provided during the current reporting period in the textbox under Traineeship. Total amount reported should account for all BHW dollars including those applied to salary, fringe benefits, travel expenses, conference expenses, tuition, fees, and reasonable living expenses, as allowed by federal statutes and regulations (do not report salary or benefits for faculty).
If the individual did not receive a financial award, select "No" in Column 12 (Block 11) and enter "0" in Traineeship column where no money was disbursed.

Enter Individual's Financial Award Amount (BHW funds only): Fellowship:

If the individual is a resident, fellow, or faculty and received a BHW-funded financial award, enter the total amount of BHW dollars provided during the current reporting period in the textbox under Fellowship. Total amount reported should account for all BHW dollars including those applied to salary, fringe benefits, travel expenses, conference expenses, tuition, fees, and reasonable living expenses, as allowed by federal statutes and regulations (do not report salary or benefits for faculty).
If the individual did not receive a financial award, select "No" in Column 12 (Block 11) and enter "0" in Fellowship column where no money was disbursed.

Enter Individual's Financial Award Amount (BHW funds only): Academic Year Total:

IND-GEN - Entering # of Academic Years the Individual has Received BHW Funding

Enter # of Academic Years the Individual has Received BHW Funding
(22) Block 12

Figure 16. IND-GEN - Entering # of Academic Years the Individual has Received BHW Funding

Enter # of Academic Years the Individual has Received BHW Funding: Select the cumulative number of academic years that each student has received a BHW-funded financial award by clicking on the drop-down menu under Column 22 and choosing one of the following options:

0
1
2
3
4
5 or more

Note
The number of academic years receiving BHW-funded financial awards does not need to be consecutive; rather, the cumulative total number of years should be reported.

Note
If an individual has received money for ½ an academic year, please round up. For example, if a student or faculty member has received a financial award for 1 ½ years, enter 2 in Column 22 (Block 12).

Note
If a faculty received a BHW-funded financial award for the first time during the current reporting period, select "1" in Column 22 (Block 12).

IND-GEN - Selecting Individual's Academic or Training Year

Select Individual's Academic or Training Year
(26) Block 15

Figure 17. IND-GEN - Selecting Individual's Academic or Training Year

Select Individual's Academic or Training Year: Select each student's current training year by clicking on the drop-down menu under Block 15 and choosing one of the following options:

Fellowship Year 1
Fellowship Year 2
Fellowship Year 3
Residency Year 1
Residency Year 2
Residency Year 3
Residency Year 4

IND-GEN - Selecting any HHS Priority Topic Area on which an Individual Received Training

Select any HHS Priority Topic Area on which an Individual Received Training
(26b) Block 15

Figure 18. IND-GEN - Selecting any HHS Priority Topic Area on which an Individual Received Training

Select any HHS Priority Topic Area on which an Individual Received Training: Use the dropdown menu in Column 26b to select all that apply from the list of topic areas on which the individual was trained.

Individual received provider resilience training
Individual received training in Health Equity
Individual received training in medications for opioid use disorder (MOUD)
Individual received training in substance use treatment
Individual received training on integrated behavioral health in primary care
Individual received training related to maternal health
None of the above

IND-GEN - Selecting Profession and Discipline/Specialty

Select Individual's Profession	Select Individual's Primary Discipline/Specialty
(26c)	(26d)

Figure 19. IND-GEN - Selecting Profession and Discipline/Specialty

Select Individual's Profession: Select the individual’s profession by clicking on the drop-down menu in Column 26c and selecting one of the available options.

Dentistry
Medicine

Select Individual's Primary Discipline/Specialty: Select the individual’s discipline/specialty by clicking on the drop-down menu in Column 26d and choosing from one of the available options. Please note that you must select a discipline/specialty that is associated with the profession you selected in Column 26c. The disciplines/specialties are organized by profession in the drop-down; please scroll to find the correct option.

DENTISTRY OPTIONS (please select)
General Dentistry
Pediatric
MEDICAL OPTIONS (please select)
Family Medicine
Geriatric Medicine
Internal Medicine
Internal Medicine/Pediatrics
Obstetrics and Gynecology
Pediatrics
Psychiatry

IND-GEN - Entering Total # of Patients Treated during Academic Year

Enter Total # of Patients Treated during Academic Year
(27c) Block 16

Figure 20. IND-GEN - Entering Total # of Patients Treated during Academic Year

Enter Total # of Patients Treated during Academic Year: In Column 27c, enter the total number of patients treated by each individual during the academic year.

IND-GEN - Entering Telehealth Training Information

Training in Telehealth	Training in Telehealth	Training in Telehealth
Select Whether Individual Received Training	Enter # of Contact Hours	Enter # of Patient Encounters
(27d)	(27e)	(27f)

Figure 21. IND-GEN - Entering Telehealth Training Information

Training in Telehealth: Select Whether Individual Received Training: Select whether each individual received clinical or experiential training in telehealth during the current reporting period by clicking on the drop-down menu in Column 27d and choosing one of the following options:

Training in Telehealth: Enter # of Contact Hours:

If the individual received clinical or experiential training in Telehealth, enter the total number of hours spent offering telehealth services and/or participating in training about how to offer telehealth services during the current reporting period in the textbox in Column 27e.
If the individual did not receive clinical or experiential training in Telehealth, leave the textbox in Column 27e blank.

Training in Telehealth: Enter # of Patient Encounters:

If the individual received clinical or experiential training in Telehealth, enter the number of telehealth patient encounters in this setting during the current reporting period in Column 27f.
If the individual did not receive clinical or experiential training in Telehealth, leave the textbox in Column 27f blank.

IND-GEN - Entering Training Information in a Primary Care Setting

Warning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully.

Training in a Primary Care Setting	Training in a Primary Care Setting	Training in a Primary Care Setting
Select Whether Individual Received Training	Enter # of Contact Hours	Enter # of Patient Encounters
(28) Block 17	(29) Block 17a	(30) Block 17b

Figure 22. IND-GEN - Entering Training Information in a Primary Care Setting

Training in a Primary Care Setting: Select Whether Individual Received Training: Select whether each resident or fellow received clinical or experiential training in a primary care setting during the current reporting period by clicking on the drop-down menu in Column 28 (Block 17) and choosing one of the following options:

Training in a Primary Care Setting: Enter # of Contact Hours:

If the resident or fellow received clinical or experiential training in a primary care setting, enter the total number of hours spent in this type of setting during the current reporting period in the textbox in Column 29 (Block 17a).
If the resident or fellow did not receive clinical or experiential training in a primary care setting, leave the textbox in Column 29 (Block 17a) blank.

Training in a Primary Care Setting: Enter # of Patient Encounters:

If the resident or fellow received clinical or experiential training in a primary care setting, enter the total number of patient encounters in this type of setting during the current reporting period in the textbox in Column 30 (Block 17b).
If the resident or fellow did not receive clinical or experiential training in a primary care setting, leave the textbox in Column 30 (Block 17b) blank.

Warning
Select "N/A" in the drop-down menu in Column 28 (Block 17) for faculty.

IND-GEN - Entering Training Information in a Medically Underserved Community

Warning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully.

Training in a Medically Underserved Community	Training in a Medically Underserved Community	Training in a Medically Underserved Community
Select Whether Individual Received Training	Enter # of Contact Hours	Enter # of Patient Encounters
(31) Block 18	(32) Block 18a	(32a) Block 19

Figure 23. IND-GEN - Entering Training Information in a Medically Underserved Community

Training in a Medically Underserved Community: Select Whether Individual Received Training:

Select whether each individual received clinical or experiential training in a medically underserved community during the current reporting period by clicking on the drop-down menu in Column 31 and choosing one of the following options:

Training in a Medically Underserved Community: Enter # of Contact Hours:

If the individual received clinical or experiential training in a MUC, enter the total number of hours spent in this type of setting during the current reporting period in the textbox in Column 32.
If the individual did not receive clinical or experiential training in a MUC, leave the textbox blank.

Training in a Medically Underserved Community: Enter # of Patient Encounters :

If the individual received clinical or experiential training in a MUC, enter the number of patient encounters in a medically underserved community during the current reporting period in Column 32a.
If the individual did not receive clinical or experiential training in a MUC, leave the textbox in Column 32a blank.

IND-GEN - Entering Training Information in a Rural Area

Warning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully.

Training in a Rural Area	Training in a Rural Area	Training in a Rural Area
Select Whether Individual Received Training	Enter # of Contact Hours	Enter # of Patient Encounters
(33) Block 19	(34) Block 19a	(34aa) Block 19

Figure 24. IND-GEN - Entering Training Information in a Rural Area

Training in a Rural Area: Select Whether Individual Received Training:

Select whether each individual received clinical or experiential training in a rural area during the current reporting period by clicking on the drop-down menu in Column 33 (Block 19) and choosing one of the following options:

Training in a Rural Area: Enter # of Contact Hours:

If the individual received clinical or experiential training in a rural area, enter the total number of hours spent in this type of setting during the current reporting period in the textbox.
If the individual did not receive clinical or experiential training in a rural area, leave the textbox blank.

Training in a Rural Area: Enter # of Patient Encounters:

If the individual received clinical or experiential training in a rural area, enter the total number of patient encounters in this setting during the current reporting period in Column 34aa.
If the individual did not receive clinical or experiential training in a rural area, leave the textbox blank.

IND-GEN - Entering Total # of Patient Encounters Across All Settings Including Inpatients

Enter Total # of Patient Encounters Across All Settings Including Inpatients
(34ab) Block 19

Figure 25. IND-GEN - Entering Total # of Patient Encounters Across All Settings Including Inpatients

Enter Total # of Patient Encounters Across All Settings Including Inpatients: For each individual, enter the number of patient encounters across all settings, including inpatients, during the current reporting period in Column 34ab.

IND-GEN - Selecting Whether Individual Left the Program Before Completion

Select Whether Individual Left the Program Before Completion
(36) Block 21

Figure 26. IND-GEN - Selecting Whether Individual Left the Program Before Completion

Select Whether Individual Left the Program Before Completion: Select whether each individual permanently left their residency or fellowship program or faculty development program before completion during the current reporting period by clicking on the drop-down menu in Column 36 (Block 21) and choosing one of the following options:

IND-GEN - Selecting Reason for Attrition or Inactive Status

Select Reason for Attrition or Inactive Status
(36a)

Figure 27. IND-GEN - Selecting Reason for Attrition or Inactive Status

Select Reason for Attrition or Inactive Status: Select the primary reason each individual discontinued participation by clicking on the drop-down menu under Column 36a and choosing one of the following options:

Administrative Error
Emotional/physical/mental exhaustion (burnout)
Failure to meet program requirements
Family obligations
Financial obligations
Medical leave of absence
Military/Active duty
Patient/Professional Workload
Other
None of the Above
N/A

IND-GEN - Entering Graduation/Completion Information

Warning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully.

Select Whether Individual Graduated/Completed the Program	Select Individual's Post-Graduation/Completion Intentions
(37) Block 22	(39) Block 22b

Figure 28. IND-GEN - Entering Graduation/Completion Information

Select Whether Individual Graduated/Completed the Program: Select whether each individual completed from their training program during the current reporting period by clicking on the drop-down menu in Column 37 (Block 22) and choosing one of the following options:

Select Individual's Post-Graduation/Completion Intentions:

Individual intends to apply for NHSC Loan Repayment
Individual intends to practice or continue practicing at a state, local, or tribal health department
Individual intends to practice or continue practicing in a medically underserved area
Individual intends to practice or continue practicing in a primary care setting
Individual intends to practice or continue practicing in a rural area
None of the above
Not Reported
N/A

Warning
None of the above, Not reported, and N/A cannot be selected in combination with any other option.

To Complete the Form: Click on the “Save and Validate” button located on the bottom right corner of your screen. If no errors are found, the BPMH system will automatically route you to the next required subform.

IND-GEN - Entering Individual's Employment Data

Warning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully.

Employment Data	Employment Data	Employment Data	Employment Data	Employment Data	Employment Data	Employment Data
Select whether Employment Data is available?	Select Whether Your Organization Hired this Individual	Select Whether a Partner Organization Hired this Individual	Enter Zip Code	City (Auto-Populates)	State (Auto-Populates)	Select Type of Employment
(56)	(56a)	(56b)	(57)	(58)	(59)	(60)

Figure 29. IND-GEN - Entering Individual's Employment Data

Select whether Employment Data is available?: Select whether employment data are available by clicking on the drop-down menu in Column 56 and choosing one of the following options:

Yes
Yes (outside U.S.)
No
N/A

Select Whether Your Organization Hired this Individual:

Select Whether a Partner Organization Hired this Individual:

Enter Zip Code: Enter the zip code for the individual’s Employment Location.
Enter City:
Enter State:
Select Type of Employment:

If ‘Yes’ was selected in Column 56, identify the individual’s type of employment by clicking on the drop-down menu and selecting the best option among those listed below.
If ‘No’ or ‘Yes (outside U.S.)' was selected, select 'N/A' in Column 60.

Academic Institution
Academic Medical Center
Area Health Education Center
Certified Community Behavioral Health Clinic (CCBHC)
Community Behavioral Health/Mental Health Center
Community Health Center (CHC)
Critical Access Hospital
Federal Government
FQHC or Look-Alike
Health Department (local/state/tribal)
Hospital (non-academic)
Indian Health Service (IHS)/Tribal/Urban Indian Health Center
Nursing Home
Other Clinical Health Setting
Other Community-Based Organization
Other Long-term Care Facility
Other Specialty Clinic
Private Industry
Private Practice
Residential Living Facility (including independent and assisted living)
Rural Health Clinic
School-based Clinic
State or Local Government
US Armed Forces
Veterans Affairs Healthcare (e.g. VA hospital or clinic)
Pursuing Additional Education or Training
Not Currently Employed
N/A

Warning
For Column 60, None of the above, not reported, and N/A cannot be selected in combination with any other option.

Note
If an individual has completed the program but is not currently employed, please select “Yes” for Column 56 (Select whether employment data is available). Leave the zip code, city, and state blank and select "N/A" for whether you or a partner organization hired the individual (Columns 56a and 56b). Then, select “Not Currently Employed” for Column 60 and N/A for Column 61.

Note
You must also select “N/A” if you indicated that the person is “Not Currently Employed” in Column 60.

Note
Leave the zip code blank if you indicated that the person is “Not Currently Employed” in Column 60.

IND-GEN - Selecting Individual's Employment Location Settings

Employment Data
Select Individual's Employment Location Settings
(61)

Figure 30. IND-GEN - Selecting Individual's Employment Location Settings

Select Individual's Employment Location Settings: For each individual, use the drop-down menu in Column 61 to select all that apply from the list of employment location settings.

Medically Underserved Community
National Health Service Corps (NHSC)-Approved Site
Primary Care Setting
Rural Area
None of the Above
N/A

To Complete the Form: Click on the "Save and Validate" button located on the bottom right corner of your screen. If no errors are found, the BPMH system will automatically route you to the next required subform.

HRSA Electronic Handbooks

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Program Manual

Teaching Health Center Planning and Development Program

IND-GEN: Individual Characteristics

IND-GEN - Setup

IND-GEN - Setup

IND-GEN - Selecting Type of Training Program

IND-GEN - Selecting Type of Training Program

IND-GEN - Entering Trainee Unique ID

IND-GEN - Entering Trainee Unique ID

IND-GEN - Entering NPI Number

IND-GEN - Entering NPI Number

IND-GEN - Selecting Individual's Training or Awardee Category

IND-GEN - Selecting Individual's Training or Awardee Category

IND-GEN - Selecting whether Individual is an IMG

IND-GEN - Selecting whether Individual is an IMG

IND-GEN - Selecting Individual's Enrollment/Employment Status

IND-GEN - Selecting Individual's Enrollment/Employment Status

IND-GEN - Selecting Individuals Gender

IND-GEN - Selecting Individuals Gender

IND-GEN - Entering Year of Birth

IND-GEN - Entering Year of Birth

IND-GEN - Selecting Individual's Ethnicity

IND-GEN - Selecting Individual's Ethnicity

IND-GEN - Selecting Individual's Race

IND-GEN - Selecting Individual's Race

IND-GEN - Selecting if Individual is from a Rural Residential Background

IND-GEN - Selecting if Individual is from a Rural Residential Background

IND-GEN - Selecting if Individual is from a Disadvantaged Background

IND-GEN - Selecting if Individual is from a Disadvantaged Background

IND-GEN - Selecting Individual's Veteran Status

IND-GEN - Selecting Individual's Veteran Status

IND-GEN - Entering BHW-Funded Financial Award Information

IND-GEN - Entering BHW-Funded Financial Award Information

IND-GEN - Entering # of Academic Years the Individual has Received BHW Funding

IND-GEN - Entering # of Academic Years the Individual has Received BHW Funding

IND-GEN - Selecting Individual's Academic or Training Year

IND-GEN - Selecting Individual's Academic or Training Year

IND-GEN - Selecting any HHS Priority Topic Area on which an Individual Received Training

IND-GEN - Selecting any HHS Priority Topic Area on which an Individual Received Training

IND-GEN - Selecting Profession and Discipline/Specialty

IND-GEN - Selecting Profession and Discipline/Specialty

IND-GEN - Entering Total # of Patients Treated during Academic Year

IND-GEN - Entering Total # of Patients Treated during Academic Year

IND-GEN - Entering Telehealth Training Information

IND-GEN - Entering Telehealth Training Information

IND-GEN - Entering Training Information in a Primary Care Setting

IND-GEN - Entering Training Information in a Primary Care Setting

IND-GEN - Entering Training Information in a Medically Underserved Community

IND-GEN - Entering Training Information in a Medically Underserved Community

IND-GEN - Entering Training Information in a Rural Area

IND-GEN - Entering Training Information in a Rural Area

IND-GEN - Entering Total # of Patient Encounters Across All Settings Including Inpatients

IND-GEN - Entering Total # of Patient Encounters Across All Settings Including Inpatients

IND-GEN - Selecting Whether Individual Left the Program Before Completion

IND-GEN - Selecting Whether Individual Left the Program Before Completion

IND-GEN - Selecting Reason for Attrition or Inactive Status

IND-GEN - Selecting Reason for Attrition or Inactive Status

IND-GEN - Entering Graduation/Completion Information

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