Get the free I ATTEST THAT I HAVE HAD NO PROVIDER RELATIONSHIP WITH

MARSHALL UNIVERSITY MEDICAL CENTER FACULTY EVALUATION OF STUDENT PERFORMANCE PRECEPTOR/ATTENDING NAME: MUS OM COURSE # : PLEASE RETURN THIS FORM TO: Michelle Rupert, Registrar 1600 Medical Center

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How to Fill Out "I Attest That I":

1. Start by carefully reading the instructions provided for the document or form requiring the "I attest that I" statement. This will help you understand the purpose and requirements of the statement.
2. Write your full name in the designated space. It is important to provide your legal name as it appears on official documents.
3. In the next line or section, indicate the date on which you are filling out the statement. Ensure that the format of the date matches the required format specified on the document.
4. Read the statement, "I attest that I," carefully and understand its meaning. This statement typically requires you to confirm the accuracy and truthfulness of the information provided in the document or form.
5. Consider the purpose of the document and the specific information you are providing. Ensure that you understand the implications and consequences of the statement, as making false or misleading statements can have legal consequences.
6. Review the information you have provided in the document or form, ensuring its accuracy and completeness. Verify any facts, numbers, or details that may be required.
7. Sign the statement by affixing your signature in the designated space provided. Your signature signifies your agreement with the statement and confirms your understanding of its contents.

Who Needs "I Attest That I":

1. Individuals applying for certain licenses or certifications may be required to fill out the "I attest that I" statement. This is usually to declare their compliance with specific regulations or requirements.
2. Professionals working in regulated industries, such as healthcare or finance, may need to attest to their adherence to professional codes of conduct or ethical guidelines.
3. Individuals involved in legal proceedings or signing legal documents may also be required to provide an "I attest that I" statement, affirming the accuracy of the information provided.

In summary, whether you are applying for a license, working in a regulated industry, or involved in legal matters, you may encounter situations where you need to fill out an "I attest that I" statement. It is crucial to understand the instructions, provide accurate information, and sign the statement as required. Always consult the specific requirements and guidelines provided to ensure compliance.

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