Get Ks Section 12 Attestation/consent And Release Form 2020-2026

Filling out the KS Section 12 Attestation/Consent And Release Form is essential for those seeking credentialing with Plan/Network. This guide will provide you with clear, step-by-step instructions to complete the form online accurately and efficiently.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering your full name as it will appear in your professional credentials. This includes your first name, middle initial (if applicable), and last name.
3. Provide your contact information, including your email address and phone number. Ensure this information is current, as it may be used for future communications regarding your application.
4. In the section that addresses your professional credentials, outline your educational background, including the names of institutions attended, degrees earned, and dates of graduation.
5. Next, include any relevant work experience. This should detail your current and past positions, the organizations you've worked for, and the duration of your employment.
6. You will need to authorize Plan/Network to obtain specific information regarding your professional history. Read this section carefully and check the appropriate boxes to confirm your consent.
7. As you review the form, take note of any fields that require your signature. These typically affirm your agreement to the terms outlined in the form.
8. Once you have completed all sections of the form, save your changes. You should also download, print, or share the completed form as necessary for your records and submission purposes.

Complete your KS Section 12 Attestation/Consent And Release Form online today to ensure your credentialing process begins smoothly.