Tufts Health Plan Senior Care Options Model of Care Training Attestation

I hereby attest that I have reviewed the Tufts Health Plan Senior Care Options Model of Care (MOC) training and that individuals in my organization providing care to patients have been trained on this topic. I recognize my role and my staff members' role in improving health outcomes for our most vulnerable population. I also understand that this training is mandated on an annual basis by CMS and by Point32Health for all providers who care for Tufts Health Plan Senior Care Options members. All fields with an asterisk (*) require input.

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* 1. Your name:

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* 2. Your title:

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* 3. Your Email address:

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* 4. Name of your organization:

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* 5. Provider NPI:

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* 6. Provider Tax ID: