Training Certificate Upload Form
Use this form to upload copies of your annual training certificates as they are completed. Do Not Send Them Through Email Please. Thank you.
Name
*
First Name
Last Name
Which Training Certificate are you uploading? (Please submit one attachment per form submission)
*
Please Select
AHIP
FFM
CE
Aetna
Alignment
Amerigroup
BS of FL
BCBS (CA)
BCBS (TX, IL, OK, NM, MT)
BCBS (RI)
Christus Health
Cigna MA
Community Health Choice (MA DSNP)
Devoted Health
Humana
Imperial
Kaiser
Kelsey Care Advantage
Memorial Hermann
Molina
Oscar
Prominence
Scott and White
Shared Health
United Healthcare
Verda
Wellcare
Other (Enter name in the field below)
If Other, please enter the certificate name below.
Certification Year
*
Please Select
2025
2026
2027
2028
2029
2030
Completion Date
*
-
Month
-
Day
Year
Date
Please upload a copy of your certificate(s) of completion below. Please upload ONE certificate per submission. Thank you.
*
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