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Regional Campuses: Honors in Underserved Primary Care (HUPC)
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  6. HRSA Grant Budget Request Form

HRSA Grant Budget Request Form

Before filling out this form, please obtain all appropriate approvals, signatures and documentation needed for final processing. Attach all supporting documentation, such as signed official function forms, event request forms, quotes, signed contracts, list of students and MPY numbers, etc. in the file upload at the bottom of the form.

MM slash DD slash YYYY
Recipient's Name(Required)

Possible Grant Objectives

  • Objective 1: Enhance pre-medical recruitment and retention strategies to increase the number of students from Arkansas’ rural and/or MUCs enrolling in the UAMS COM, and who ultimately return to practice in rural and/or MUC primary care settings in Arkansas.
  • Objective 2: Standardize performance improvement activities, communications and evaluation processes to effectively document, track, measure, and disseminate findings and outcomes for this project and all community- based primary care initiatives.
  • Objective 3: Expand UAMS COM curricular offerings that include clinical, didactic, and community-based training activities, with an emphasis on the care of vulnerable populations in rural communities and/or medically underserved communities, to increase selection of residency programs in family medicine, general internal medicine, general pediatrics, or combination of internal medicine and general pediatrics.
  • Objective 4: Increase community-based clinical/experiential opportunities in rural and/or MUC primary care clinical training sites by leveraging strategic partnerships across the state.
  • Objective 5: Develop and implement a Faculty/Staff Development series designed specifically for new preceptors/teaching clinicians.
  • None of the above
NOTE: The goal of the MSE program is to increase the number of primary care physicians practicing in the top quintile of states with a projected primary care provider shortage in 2025.
Which grant objective is satisfied by your request?(Required)
NOTE: The goal of the MSE program is to increase the number of primary care physicians practicing in the top quintile of states with a projected primary care provider shortage in 2025.

Possible Grant Objectives

  • Objective 1: Recruit, retain and graduate medical students from tribal, rural, and/or medically underserved communities who are interested in practicing in these areas following residency training.
  • Objective 2: Increase the number of medical school graduates who select residency programs in family medicine, general internal medicine, general pediatrics, or combination of internal medicine and general pediatrics to increase the primary care physician workforce in tribal, rural and medically underserved communities.
  • Objective 3: Develop or enhance strategic partnerships, including one or more rotations in primary care such as at a teaching health center or community-based setting to collaborate on educational and training activities for the medical students.
Which grant objective is satisfied by your request?(Required)

Possible Grant Objectives

  • Objective 1: Improve the quality of training by standardizing curricular didactic topics, rotational goals and objectives; strengthening faculty teaching skills and incorporating clinical rotations in rural and MUC areas
  • Objective 2: Increase the number of UAMSRP Family Medicine residents with experience in rural and/or underserved clinical settings.
  • Objective 3: Establish new Family Medicine Rural Residency Programs and/or Rural Training Programs.
  • Objective 4: Assist rural communities in recruiting graduates to practice in rural and/or underserved areas.
Which grant objective is satisfied by your request?(Required)
Is this request supported within the narrative of the budget?(Required)
Name of person completing this form(Required)
If the person submitting this form is different from the fund recipient.
If the person submitting this form is different from the fund recipient.
Drop files here or
Max. file size: 15 MB.
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