I promise that I will not submit any claim to Medicare for any item or service provided to any Medicare beneficiary during the 2-year periods beginning on the following effective date: ______________________; nor will I permit any entity acting on my behalf to submit a claim to Medicare for services furnished to a ...
Dear Principal Name, I wanted to let you know that my child, name, will not take part in the name the test this year. We ask that you make arrangements for him/her to have a productive educational experience during the testing period. Thank you for all you do.