Verification of Client Contact Signature
1. Verification of Client Contact form needs to be completed monthly.
2. Each client should have their own form.
3. The service month is the month you provided services.
4. Complete form. Example provided below.
5. Verification of Client Contact form needs to be turned in by end of month via email or office.
6. Case Managers will use form to verify your monthly reports.
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Your legal name
Your email address
Signed by Alisha Jackson
Signed On: July 16, 2022
If you have questions about the contents of this document, you can email the document owner.
Document Name: Verification of Client Contact Signature
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