(1) Applications shall be in such form as the Board of Regents may require and shall contain the following information:
- (a) Evidence of health or dental care professional educational program attendance.
- (b) Evidence of licensure or certification as a nurse-midwife, nurse practitioner, dental hygienist or physician assistant.
- (c) Evidence of educational loan indebtedness and educational loan outstanding balance.
- (d) The location of the applicant’s current or proposed practice.
- (e) Evidence that the provider practices or will practice primary care in an eligible practice area.
- (f) The length of time the health care provider has practiced in the eligible practice area.
- (g) Information about the likelihood that the applicant will remain in the eligible practice area after the loan repayment period.
- (h) Any other information the Board of Regents may require to make a determination in accordance with the provisions of s. 36.61, Stats., and this chapter.
- (2) The Board of Regents shall prepare application materials that it may update as necessary.
History
History: Cr. Register, June, 1998, No. 510, eff. 6-1-98; CR 01-157: am. (1) (a) and (b), Register June 2002 No. 558, eff. 7-1-02; correction in (1) (intro.), (h), (2) made under s. 13.92 (4) (b) 6., 7., Stats., Register October 2011 No. 670; 2015 Wis. Act 330 s. 20: am. (1) (intro.), (h), (2) Register April 2016 No. 724, eff. 5-1-16.