Education module

MEDICARE ANNUAL WELLNESS VISIT MODULE

View the educational video, then attest your completion in the form below to receive credit for fulfilling the NHN’s active engagement criteria.

EDUCATION MODULE

Meidcare Annual Wellness Visit Education Module

Attestation Form

Please complete the attestation form below if you would like to receive credit for fulfilling NHN's active engagement requirement for Network physicians.

Name *

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Did you watch the module independently or as a group?

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As a group

You can enter up to three additional attendees in the form below. If you have four or more attendees, please upload an Excel file listing the participant's name, email and NPI Number.

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Department or Practice Name

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Email *

NPI Number

On a scale of one to five, please rate your overall satisfaction with the module:

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Overall Satisfaction Not satisfied	Overall Satisfaction Somewhat satisfied	Overall Satisfaction Neutral	Overall Satisfaction Satisfied	Overall Satisfaction Very Satisfied

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Education module

MEDICARE ANNUAL WELLNESS VISIT MODULE

EDUCATION MODULE

Meidcare Annual Wellness Visit Education Module

Attestation Form

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