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HRSA Electronic Handbooks

State Oral Health 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

SOHWP-A: New Facilities

If your program established new dental facilities in a HPSA/underserved area, select ‘Yes’ and complete the table below, otherwise select ‘No’ and proceed to the next form. 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.



Did your program establish new dental facilities in a HPSA/Underserved area? (Block 1)
(complete table below)(proceed to the next form)
Add Facility


No.Facility Name
(1)
Block 1b
Select the Type of Facility
(2)
Block 1a
Select Type(s) of Oral Health Services Provided
(3)
Block 1c
Enter # of Patient Encounters
(4)
Block 1d
Select whether this is a Mobile/Portable Facility
(5)
Block 1e
Option(s)

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