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  • Phs 6289 Form

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U.S. Department of Health and Human Services Commissioned Corps of the U.S. Public Health Service CB USE ONLY DATE REC. DENTAL SPECIAL PAY (DSP) CONTRACT REQUEST (Privacy Act Notice on Page 2) 1 a.

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How to fill out the Phs 6289 Form online

The Phs 6289 form is an essential document for individuals seeking Dental Special Pay (DSP) through the Commissioned Corps of the U.S. Public Health Service. This guide will walk you through each step of filling out the form online, ensuring you provide all necessary information accurately.

Follow the steps to complete the Phs 6289 form online.

  1. Click the ‘Get Form’ button to access the Phs 6289 form. This action will open the form in your chosen editor, ready for you to input your information.
  2. In the identification section (1), fill in your name (last, first, and middle initial), grade/rank, PHS serial number, organization, duty phone number, and social security account number (SSAN). Ensure all spellings and numerical entries are correct.
  3. Move on to special pay(s) requested (2). Check the boxes for the relevant special pay options that apply to your request: Additional Special Pay (ASP), Multiyear Retention Bonus (MRB), or Incentive Special Pay (ISP) for Oral and Maxillofacial Surgeons.
  4. In the conditions of the contract (3), read each statement carefully. Sign and date to agree to the terms. Initial the box corresponding to the length of active duty you are agreeing to (12, 24, 36, or 48 months).
  5. Further details may need to be completed regarding the effective date of your contract, including any specific conditions for initial and subsequent contracts. Make sure to provide the correct date formats.
  6. In the certification section (4), sign and date to certify your understanding of, and agreement to, the terms outlined in the contract.
  7. The notarization section (5) requires the form to be signed in front of a notary. Fill in the necessary details and have the notary complete their section.
  8. Complete the supervisor certification (6) and operating division/program certification (7) sections. These require additional signatures and dates from your supervisors to validate your eligibility.
  9. Review the entire form for any errors or omissions. Make corrections as necessary to ensure all information is complete and accurate.
  10. Finally, save your changes. You may have the option to download, print, or share the completed form as needed.

Start filling out the Phs 6289 form online today to ensure your eligibility for Dental Special Pay.

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PHS stands for Public Health Service, a crucial entity in maintaining public health standards. When reviewing documents like the Phs 6289 Form, recognizing this abbreviation is vital for understanding legal health requirements. This background can help individuals make informed decisions about their health documentation. Platforms like uslegalforms offer support to ensure you have the right tools for compliance.

The full form of PHS is Public Health Service, an organization dedicated to enhancing the health of American citizens. In relation to the Phs 6289 Form, it provides essential guidelines that aid in health assessments and regulations. Understanding this terminology can improve compliance with public health standards. For assistance with any related forms, uslegalforms serves as a reliable platform for finding necessary resources.

In chat terminology, PHS can refer to a Public Health System chat where users discuss health-related topics. It's crucial, especially when dealing with documents like the Phs 6289 Form, to engage in meaningful conversations about health regulations. This ensures that individuals can obtain accurate information. Uslegalforms offers resources that help clarify any doubts regarding forms and legal procedures.

PHS stands for Public Health Service. Within the context of the Phs 6289 Form, it may relate to guidelines and documentation linked to public health regulations. This understanding is essential when dealing with forms that govern public health practices. Utilizing services like uslegalforms simplifies acquiring and completing necessary paperwork.

PSH typically stands for Public School Health. However, in the context of the Phs 6289 Form, it represents important legal and healthcare documentation. This form plays a critical role in ensuring that health records are maintained accurately. Understanding the terminology helps in navigating related processes effectively.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232