Army Active Duty Health Professions Loan Repayment
This file outlines the details and requirements for the Army Active Duty Health Professions Loan Repayment Program. It provides guidance for applicants to ensure compliance for eligibility. Follow the instructions carefully to complete and submit your application.
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How do I fill this out?
Filling out this form involves understanding your responsibilities as an applicant in the ADHPLRP process. You will need to ensure all required documents are collected and submitted within the designated timeframes. Review each section carefully prior to beginning the completion of the application.

How to fill out the Army Active Duty Health Professions Loan Repayment?
1
Read through the checklist and guidelines provided in the form.
2
Complete the required forms as indicated on the checklist.
3
Sign the Letter of Intent with your recruiter.
4
Submit all necessary documents to the OTSG within the six-month timeframe.
5
Keep a copy of all submitted documents for your records for five years.
Who needs the Army Active Duty Health Professions Loan Repayment?
1
Recent graduates from medical programs seeking loan repayment assistance.
2
Military healthcare professionals planning to apply for the ADHPLRP.
3
Recruiters who need to assist applicants in the enrollment process.
4
Individuals transitioning from prior service into active duty healthcare roles.
5
Anyone interested in understanding their eligibility for the loan repayment program.
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What are the instructions for submitting this form?
To submit your completed form, email it to the designated address provided in the guidelines. You can also fax your application to the provided number or send via traditional mail to the specified address. Ensure that you retain a copy of your submission for your records.
What are the important dates for this form in 2024 and 2025?
Important dates for this form include the submission deadlines within six months post-BOLC completion, along with any specific enrollment or training dates set forth by the program. Applicants must ensure they keep track of these deadlines to maintain their eligibility. Staying aware of these timelines will help prevent any loss of eligibility for the loan repayment program.

What is the purpose of this form?
The purpose of this form is to provide applicants with detailed instructions and requirements for enrollment in the Army Active Duty Health Professions Loan Repayment Program. It serves as a formal declaration of intent for individuals wishing to take advantage of the loan repayment benefits available to healthcare professionals in the military. By outlining necessary actions and deadlines, this form ensures that applicants submit complete and accurate information to the Office of the Surgeon General.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant Name: Full name of the applicant.
- 2. Applicant Signature: Signature confirming the applicant's intent.
- 3. Date: Date the form is completed.
- 4. Recruiter Name and RSID: Name of the recruiter assisting the application.
- 5. Recruiter Signature: Signature of the recruiter verifying the application.
What happens if I fail to submit this form?
Failure to submit this form may result in the loss of eligibility for the loan repayment program, affecting your financial assistance for educational debts. Applicants must adhere to the submission timelines outlined in the instruction to ensure they receive the benefits. Not submitting may also lead to complications in recruitment status and access to active duty health professions.
- Loss of Eligibility: If the application is not submitted on time, the applicant may lose their chance to receive loan repayment benefits.
- Recruitment Impact: Delayed or missed submissions can adversely affect recruitment processes.
- Financial Constraints: Failure to secure repayment may lead to heightened financial burdens for applicants with significant educational debt.
How do I know when to use this form?

- 1. Application Process: Utilized when applying for the ADHPLRP to secure loan repayment.
- 2. Verification of Intent: Serves as a declaration of the applicant's intentions and responsibilities.
- 3. Documentation Submission: Used to compile and submit necessary documents to OTSG.
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How can I ensure my form is filled out correctly?
Carefully follow the guidelines and checklists outlined within the PDF, and consider reviewing it with your recruiter.
What is the process for submitting the completed form?
Once your form is completed, you can submit it via email, fax, or physical mail according to the provided instructions.
Can I get assistance with filling out the form?
Yes, reach out to your recruiter for guidance on filling out the application properly.
What formats can I download the PDF in?
You can download the PDF in standard format for easy printing and submission.
Are there any specific deadlines I should be aware of?
Yes, please refer to the important dates section related to the ADHPLRP for any deadlines.
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