Provider Acknowledgement Form for Cultural Competency

Please complete the acknowledgement below so that you can be credited with the completion of this training. Your record in the Optima Health provider directory will be updated to reflect that you have participated in training for Cultural Competency.

I acknowledge that I have completed the following course(s)

At least one box must be checked to continue.

"Cultural Diversity" by Optima Health

http://sentara.articulate-online.com/9094660812

and / or

"Think Cultural Health" by The U.S. Department of Health & Human Services

https://cccm.thinkculturalhealth.hhs.gov/

Your Information

All fields are required.

First Name:

Last Name:

Email Address:

NPI: