Get Rec Participant Addendum - Alaska Ehealth Network - Ak-ehealth

Completing the REC Participant Addendum is a vital step in accessing services from the Alaska EHealth Network. This user-friendly guide outlines the necessary steps to fill out the form accurately, ensuring that all required information is provided.

Follow the steps to complete the REC Participant Addendum.

1. Press the ‘Get Form’ button to acquire the form and open it in your document management tool.
2. In the first section, fill in the name of the Participant in the designated space provided.
3. Proceed to the RECITALS section, where you acknowledge the mission and vision of the Alaska eHealth Network. No specific input is needed here, but familiarizing yourself with this information is crucial.
4. In the AEHN PROVIDER SERVICES section, indicate your agreement to receive grant-funded assistance by signing where prompted.
5. Continue to the APPLICABLE TERMS AND DEFINITIONS section. Carefully review each term and fill in your acknowledgment as necessary.
6. In the CONFIDENTIAL INFORMATION section, ensure you understand what constitutes “Confidential Information.” No input is needed from you here, but be aware that this is vital for maintaining the privacy of sensitive data.
7. Move to the FEES section, and confirm your understanding of the costs associated with REC services. This is essential for budget planning and service selection.
8. In the signature area, sign and date the form in the designated spaces, ensuring all required parties are included.
9. Complete the Notice Address section by providing the necessary contact information for your organization.
10. If applicable, fill in any demographic indicators required in Appendix B, including organization details and provider information.
11. Finally, review the entire form for accuracy and completeness. Once all sections are filled out, save any changes, download a copy for your records, print it for submission, or share it with relevant parties.

Complete the REC Participant Addendum online to take full advantage of the services offered!