Get Som Exhibit 287. Authorization For Accreditation Organization To Release The Most Recent

This guide provides clear instructions on completing the SOM Exhibit 287 form, which is essential for allowing an accreditation organization to release the most recent survey for validation. Follow these steps to ensure a smooth and accurate submission process.

Follow the steps to complete your form effectively.

1. Click ‘Get Form’ button to access the SOM Exhibit 287 form and open it in your preferred editing tool.
2. In the first section, address the recipient by filling in 'To Whom it May Concern' as specified.
3. Indicate the date by entering the current date in the designated section at the top of the form.
4. In the next part, indicate the name of the provider or supplier that has been selected for the validation survey.
5. Acknowledge the necessity of the validation survey by checking the provided information about compliance with Medicare Conditions of Participation.
6. Authorize the validation survey by signing in the appropriate signature section labeled 'Signature of Authorizing Individual.'
7. Print or type your name clearly in the section for 'Printed/Typed Name of Authorizing Individual.'
8. Type the name of the provider or supplier once more in the 'Name of Provider/Supplier' section.
9. Finally, ensure you fill in the final 'Date' section to confirm when you completed the form.
10. Once all fields are completed, review the information for accuracy. You can then save changes, download, print, or share the form as needed.

Complete your SOM Exhibit 287 form online today for seamless processing.