Get Njsams

Filling out the Njsams form online is an essential step in standardizing your organization's board resolutions as required by the Department of Human Services. This guide will provide a clear, step-by-step process to help you complete the form accurately.

Follow the steps to successfully complete the Njsams form.

1. Click the ‘Get Form’ button to obtain the Njsams form and open it in your preferred editor.
2. Begin with Attachment I, where you must select one of the three options regarding your organization's status under the Health Insurance Portability and Accountability Act (HIPAA). Ensure to mark the correct choice by checking box A, B, or C as applicable.
3. If you selected option B, make sure to include the date of the most recent DHS Business Associate Agreement (BAA). This document will need to be referenced in the future.
4. Complete the second section of Attachment I, which requires you to acknowledge that no legal advice will be provided by the Department of Human Services. Ensure that board members understand and agree to seek their own legal representation if needed.
5. Proceed to Attachment II. Fill in the contract number and contract period accurately. This information is crucial for your submission.
6. Complete the fields for your agency’s name and ensure that the certification is signed by both the Chairperson of the Board of Directors and the Executive Director. Include the respective dates of signing.
7. List all authorized signatories for contracting documents. Make sure to provide their full names and titles. If necessary, add additional pages to accommodate all individuals.
8. Once all sections of the Njsams form are duly completed, review the entire document for accuracy and completeness before submission.
9. Save your changes, then download or print the completed form for your records. Ensure to share it with all necessary parties involved in the contract process.

Complete your Njsams documents online today for a smooth compliance process.