Form 8: Health Center AgreementsHealth Center Agreements • June 24th, 2022
Contract Type FiledJune 24th, 2022DEPARTMENT OF HEALTH AND HUMAN SERVICESHealth Resources and Services Administration Form 8: HEALTH CENTER AGREEMENTS FOR HRSA USE ONLY LAL Number Application Tracking Number Note: Look-alikes must be independently owned, controlled, and operated. If a Look-alike wishes to enter into an agreement/arrangement post-award that will either (1) result in another organization carrying out a substantial portion of the approved scope of project or (2) impact the governing board’s composition, authorities, functions, or responsibilities, a Prior Approval request must be submitted in EHBs and approved by HRSA before the agreement/arrangement can be formalized and implemented. PART I Health Center Agreements 1. Does your organization have a parent, affiliate, or subsidiary organization?If Yes, indicate the number of each agreement by type in 1a, 1b, or 1c below and complete Part II. If No, Part II is Not Applicable. [_]Yes [_] No 1a. Number of Parent Organizations 1b. Number of Affiliate Org