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HRSA Electronic Handbooks

Promoting Resilience and Mental Health Among Health Professional Workforce

pdf
  • Health Resources and Services Administration
  • Academic Year: 2022-2023
  • Bureau of Health Workforce
  • OMB Number: 0915-0061
  • Annual Performance Report
  • OMB Expiration Date: 01/31/2025

EXP-1: Training Site Setup

The EXP-1 Setup form captures information about the names of sites used by grantees to provide trainees with clinical or experiential training. Please enter each site used separately by typing in a site's name and clicking the ‘Add Record’ button. Please complete this setup form for each training site used. If you have any questions about how to complete this setup form, please refer to the instruction manual and/or contact your Government Project Officer. If you wish to view data that were submitted in the prior reporting period, click on the ‘View Prior Period Data’ link and a read-only version of your most recent prior performance report will pop-up in a new screen. Also, records about sites used in a prior reporting period will auto-populate into this form and are identified as ‘Prior Records’ under the column labeled "Record Status".



No.Record StatusSite Name
(1)
Block 1
Select Whether the Site was Used in the Current Reporting Period
(2)
Select Type of Site Used
(3)
Block 1a
Select Type of Setting Where the Site was Located
(4)
Block 2
Select the Primary Purpose of the Grant Partnership(s) Developed or Enhanced using BHW Funding
(5a)
Select Types of Partner Organizations for the Primary Purpose
(5b)
Select Secondary Purpose(s) of the Grant Partnership(s)
(5c)
Select Type(s) of Vulnerable Population Served at this Site
(7)
Street Address 1
(7a)
Street Address 2
(7b)
Enter Zip Code
(8)
City
(9)
State
(10)
Four Digit Zip Code Extension
(11)
Payment Model
(12)
Select any HHS Priorities Addressed at this Site
(14)
Option(s)

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