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Arizona Loan Repayment Program

Loan Repayment Contracts – Requirements

If your application has been approved, a contract will be sent to you for review and acceptance. The contract is not valid until signed by you, the contractor, and the Arizona Department of Health Services (ADHS) Procurement Office. Once the contract has been executed, ADHS Procurement Office will require a Certificate of Insurance. The insurance requirements are specified under the Special Terms and ConditionsPDF of your contract.

Once ADHS Procurement Office receives and approves the COI, the contract is fully effective. The program will begin monitoring service from the effective date of the contract by requiring the contractor to submit the following forms with original notarized signatures:

NOTES:

  • Obligated service begins on the effective date of the State contract. Services rendered prior to that effective date do not count toward the service obligation.
  • Loan repayment is issued only upon receipt and processing of the service verification and encounter report forms. Otherwise, payment may be delayed.