The commissioner may delay or defer the service obligation start date, the service obligation and/or the repayment obligation of a recipient due to extreme hardship, or to permit the recipient to continue training in primary care specifically approved by the commissioner. Extreme hardship includes, but is not limited to, serious illness or injury of the recipient or a member of the recipient's immediate family or other circumstances beyond the control of the recipient that would make it extremely difficult or impossible for the recipient to fulfill the service obligation or repayment requirements.

The commissioner may waive all or part of the service obligation and/or any repayment obligation incurred by a recipient due to extreme hardship.

A request for a deferral or waiver of a service or repayment obligation must be submitted in writing on forms prescribed by the commissioner. The commissioner may request sworn statements and appropriate documentation to support the recipient's request.

The commissioner will notify the president of any service or repayment obligation deferrals or waivers.