AmeriHealth Caritas Delaware Provider Cultural Competency/Health Equity Training Attestation Survey

1.Title of Health Equity/CLAS Training(Required.)

2.Cultural Competency/Health Equity Training Provider (company, organization, individual)(Required.)

3.Training Completion Date(Required.)

Completion Date

Date

SuSunday

MoMonday

TuTuesday

WeWednesday

ThThursday

FrFriday

SaSaturday

4.Would you like to update your provider directory listing to indicate that you have completed a Cultural Competency/Health Equity training?

Yes

No