Forms

The forms available on this webpage are for recipients of the Medical Student Loan program. Applicants DO NOT need to submit additional information other than their application (as provided by your medical school).
For a more detailed explanation of the postponement/forgiveness process, visit the How It Works section of this website. Recipients who need to submit verification of their practice should read the instructions below carefully.

Electronic Postponement/Deferment Form: This will allow you to input your information and provide your supervisor’s email address. Your supervisor will receive an email from wvColleges via Altaflow to complete their portion of the form. The form will be sent to WVHEPC for review before being transmitted to your medical school to be applied towards your Heartland ECSI account.

• Important: Follow up with your supervisor to ensure they complete their part of the form. Your form cannot be processed until they complete their part of the form.
• Firewall Alert: Some organizations have security filters that may block emails from AirSlate. If your supervisor does not receive an email from wvColleges via AirSlate in either their inbox or spam folders, please use the fillable pdf option instead.

• Pay stubs will not be accepted as proof of employment.
• We cannot directly contact your employers to verify your compliance with the loan postponement/forgiveness terms.
• If your practice is not in a geographic HPSA or a facility based HPSA, please be sure to submit proof from your employer showing that more than 50% of patients over the past 6 months are on low income programs like Medicare, Medicaid, CHIP, VA Benefits, free services, or sliding scale services to mslp@wvhepc.edu. See the How It Works section of the website for more guidance about the service criteria.
  • After you have supplied this verification once you will not have to do it again unless you change employers.