Acknowledgment Form: Receipt of Compliance Policy & Training

Acknowledgment Form: Receipt of Compliance Policy & Training

I acknowledge that I, (Print First & Last Name) _______________________, successfully completed the in-house recorded training seminar "Compliance Training 2018" on (Insert Date) ___________________.

I further acknowledge that I have been provided a copy of and have read the Compliance Training 2018 Presentation and the Agency's Compliance Policy, and I have understood it and agree to abide by its terms. I understand any employee who engages in conduct prohibited by the Policy will be subject to disciplinary action, up to and including termination.

I understand that if I have any questions about the content of the training or the Agency's Compliance Policy, I am always free to contact Jenelle Moran, Mercy Haven's Compliance Officer at jmoran@ or 631-277-8300.

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Employee Signature

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Date

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