Arizona Loan Repayment Program

Loan Repayment Application – Apply for Repayment

To apply for loan repayment, applicants must provide to the Arizona Department of Health Services a complete application packet that includes the following:

  1. Primary Care Provider Application Form
  2. Loan Information and Certification
  3. Applicant Certification and Privacy Act Release Authorization
  4. Service Site Application Form
  5. Required Supporting Documents

Applicants must also submit a Substitute W9 Form with an original signature and must register at the ProcureAZ website. The website offers step-by-step instructions on vendor registration.

Applications must be submitted to:

Workforce Section Manager
Bureau of Health Systems Development, ADHS
150 N. 18th Avenue, Suite 300
Phoenix, AZ 85007

NOTE: Only complete applications will be considered. If additional documentations are required, the program manager will contact the applicant and will be given one week to provide such requirements.

Application Submission Deadlines

The ALRP application cycle is ongoing. Applicants may submit their application at any time for consideration of a loan repayment contract. The processing time for each application may vary depending on the completeness and quality of the application received. The Program Manager will ensure that only those with complete applications are considered for an award. The standard processing time is about 6 to 8 weeks. Once the application review is complete, all applicants will be notified of the final status of their application. Denied applications will be returned to the applicant.