Get Medical Assistant Phlebotomist Training Attestation Form. A One Page Form That Applicants Applying

This guide provides a clear and supportive approach for users completing the Medical Assistant Phlebotomist Training Attestation Form online. Follow these detailed steps to ensure accuracy and completeness in your application process.

Follow the steps to successfully complete the attestation form.

1. Click ‘Get Form’ button to access the Medical Assistant Phlebotomist Training Attestation Form and open it in your browser or designated form editor.
2. Carefully fill out the applicant's demographics section. Provide your first name, middle name (if applicable), last name, date of birth, and your full address including city, state, and zip code.
3. In the Washington State Licensed Supervising Healthcare Practitioner Attestation section, the supervising healthcare practitioner must print their name clearly and affirm that the medical assistant-phlebotomist has completed the required training.
4. The supervising healthcare practitioner must then sign and date the form, providing their license number and the expiration date of that license to authenticate the attestation.
5. Review the completed form carefully to ensure all fields are filled out accurately, and confirm that all required signatures are present.
6. Once verified, save your changes, download a copy of the form, print it for your records, or share it as needed.

Complete your Medical Assistant Phlebotomist Training Attestation Form online today!