Get Mi-wic Signature Form - State Of Michigan - Michigan

The MI-WIC Signature Form is an essential document used by employees of the WIC program in Michigan to acknowledge their understanding of confidentiality, conflict of interest, and fraud compliance. This guide provides clear, step-by-step instructions for filling out the form online to ensure you complete it accurately and efficiently.

Follow the steps to fill out the MI-WIC Signature Form online.

1. Press the ‘Get Form’ button to access the MI-WIC Signature Form and open it in your editing tool.
2. Begin by entering your employee name in the designated field at the top of the form. Ensure your name matches your official documentation to avoid any discrepancies.
3. Next, fill in the agency name to indicate where you are employed. This is important for record-keeping and accountability.
4. Read through the confidentiality section carefully. It highlights the importance of keeping all client and staff information private. After reading, initial the designated space to confirm your understanding.
5. Proceed to the conflict of interest section. It is important to acknowledge that personal relationships should not influence professional duties. Initial in the provided space after you have read this section.
6. Review the employee fraud and abuse section. This part outlines actions that are considered violations of program regulations. It is crucial to understand these guidelines fully. After comprehension, initial in the designated area.
7. At the bottom of the form, provide your signature in the employee's signature space. This indicates your agreement to the terms stated.
8. Fill in your job title in the appropriate field to clarify your position within the agency.
9. Have your supervisor sign in the supervisor’s signature area to validate the form.
10. Finally, enter the date on which you are completing the form. Once all fields are correctly filled, you can save your changes, download, print, or share the form as needed.

Ensure you complete all necessary documents online to maintain compliance and confidentiality in your role.