Medicare Part D Compliance Training Acknowledgement Receipt

Reprinted from pp 58-59 of the Medicare of the Medicare Prescription Drug Manual – Chapter 9 – Part D Program to Control Fraud, Waste and Abuse.
Medicare Part D Compliance Training Acknowledgement Receipt

I acknowledge that I have received Medicare Part D Compliance training. Said training has been communicated to me in terms whereby I understand its content. I have been given ample opportunity to ask questions. By signing this acknowledgement receipt, I commit to following the standards and protocols as presented within the Medicare Part D Compliance program.
Employee Full Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Should be Empty: