The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like [email protected]). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

9aQxIegYbJm8vPRtXZwcihs7Cs3vaaQUTf4tZcFIJcn8mVr4DCBoSABz5SobEJHvwJY7AHFwrqtFa6GDCG6rnU9Q5RZh8V2ASo3nVzIh

High Needs Service Bonus Eligibility

The High Needs Service Bonus (HNSB) eligibility questionnaire is the first of a two-step application process. Based on your responses to the eligibility questions, you may be able to apply to HNSB. If you meet the pre-eligibility criteria, you will receive a personalized HNSB application link via email (second step of the application process). Your email will be requested at the end of this questionnaire.

Please review the HNSB guidelines prior to completing this questionnaire and submitting a HNSB application. This is very important for many reasons:
1). You will be asked to attest to reading them on the HNSB application;
2). You will read the specific eligibility criteria for HNSB;
3). You can start preparing the required documentation needed to be uploaded on the HNSB application if you are deemed eligible to apply.

The HNSB guidelines are located at: https://www.ncdhhs.gov/providers/provider-info/health-care/recruitment-for-providers.

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