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Supplemental Questionnaire

Last Name
First Name


**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**



Do you possess a Master's degree in Health Sciences, Health Care Administration, Public Health or Public Policy?

Yes No

What field of study is your master's degree in?


Describe your experience evaluating, analyzing, researching and developing health care services, policies, and programs.

Please include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  If you do not possess experience in this area, put N/A in the box below. 


Describe your experience conducting health care data analytics and research to include cost effectiveness and outcome-based studies.

This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.

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