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Click ‘Get Form’ to open the hs 328 cdph in the editor.
Begin by reviewing the notice regarding the effective date of provider agreements. Familiarize yourself with the federal regulations outlined in sections I and II, as they are crucial for understanding your obligations.
In the signature field, provide your signature to confirm that you have received, read, and understood the notice. This is a mandatory step for compliance.
Next, print your name clearly in the designated area below your signature. Ensure that it matches any official documentation you may have.
Finally, enter today’s date in the specified field to complete the form. This date is essential for record-keeping purposes.
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