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Written Acknowledgement I am a patient of. I hereby acknowledge receipt of OralMaxillofacial Surgery Associates of New Mexico's Notice of Privacy Practices. Name please print : Signature: Date: OR
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Ensure that you include the correct date and sign the form.
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Who needs written acknowledgement?

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Anyone who is receiving a payment, package, or any form of acknowledgment may need to fill out a written acknowledgement.
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It can be required for individuals, organizations, or businesses acknowledging the receipt of goods, services, money, or important documents.
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Written acknowledgements are often necessary for legal or administrative purposes.
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A written acknowledgement is a formal document confirming receipt or recognition of something, usually a donation or gift.
Nonprofit organizations are typically required to provide written acknowledgements to donors who make contributions.
Written acknowledgements should include details such as the date of the donation, amount donated, description of any goods or services exchanged, and the nonprofit organization's tax-exempt status.
The purpose of a written acknowledgement is to acknowledge the generosity of donors, provide them with necessary documentation for tax purposes, and maintain transparency in financial transactions.
Written acknowledgements should include the name of the donor, amount of donation, date of donation, description of any goods or services received, and a statement indicating whether any goods or services were exchanged for the donation.
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