Get Thank You For Participating In The Mhs Key Provider Partnership Outreach Program

This guide provides step-by-step instructions for completing the Thank You For Participating In The MHS Key Provider Partnership Outreach Program online. Completing this form accurately helps ensure your provider office receives the necessary educational materials and resources efficiently.

Follow the steps to fill out the form correctly.

1. Click the ‘Get Form’ button to access the form and open it in the online editor.
2. Fill in the 'Name of the Provider Office' section with the official name of your provider office.
3. Enter the 'Provider Office Address,' ensuring to include the complete street address, city, state, and ZIP code.
4. In the 'Office Contact' field, provide the name of the person responsible for handling the request.
5. Input the current date in the 'Today’s Date' field formatted as MM/DD/YYYY.
6. Complete the section for 'MHS Provider Relations Rep' by entering the name of your assigned representative.
7. In the 'Materials Requested' table, check the boxes next to the items you wish to order, followed by indicating the desired quantities in the adjacent column.
8. After filling out all required fields, review the information for accuracy and completeness.
9. Once verified, save the completed form and choose to either download, print, or share it as needed.

Complete the form online today to ensure your provider office receives the resources needed for MHS members.