Healthcare Provider Assessment

The Health Resources and Services Administration (HRSA) of the Bureau of Health Workforce (BHW) requires the Primary Care Office to regularly evaluate all primary care, mental health, and dental health providers to assess whether there is adequate primary medical, dental, or mental health care available statewide.   

The information obtained from the assessment helps provide an accurate Full-Time Equivalent (FTE) provider count, which is a critical component of the Health Professional Shortage Area (HPSA) request or update process.   
The form should take about 5-10 minutes to complete but may offer many benefits such as: 

  • Programs to recruit healthcare workers to needed areas 
  • Help with loan repayment 
  • Increased Medicare and Medicaid reimbursements 

The below professions should complete a Healthcare Provider Assessment or Online form link : 

  • Primary Care Physicians (MD or DO) 
  • Family/General Practice 
  • Internal Medicine 
  • OB/GYN 
  • Pediatrics 
  • Psychiatrists (MD or DO) 
  • Dentists (DDS or DMD) 
  • General Dentistry 
  • Pediatric Dentistry
  • Midwives

Once complete, click the “Submit by Email” button at the bottom of the form to email directly to, or print and fax to 512-776-4232.   

Note: If using Chrome, the “Submit by Email” button may not work.  If this is the case, save the PDF and manually attached to an e-mail and send to the email address above.