CDPAP PROGRAM

PERSONAL ASSISTANT ENROLLMENT PACKET

ACKNOWLEDGMENT OF RECEIPT OF POLICY PERTAINING TO FALSE CLAIMS AND FALSE STATEMENTS

I acknowledge that I have received a copy of the MEADOWS HOME CARE False Claims Act Policy. I HAVE READ STATEMENTS PERTAINING TO FALSE CLAIMS AND FALSE STATEMENTS. I have been informed by my Consumer or Designated Representative regarding the policy for Federal and State False Claims Act and False Claims Policy.