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VIRGINIA MEDICAID ERA CONTRACT INSTRUCTIONS Please carefully read all instructions here before beginning. The documents in this top section must be completed on-line and sent directly to MD On-Line

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1. Begin by carefully reading the instructions provided with the form. It is essential to understand the requirements and guidelines before proceeding.
2. Identify the sections within the form that need to be completed. These sections may include personal information, contact details, dates, signatures, and any other specific details required.
3. Take your time to gather all necessary information before filling out the form. This may include relevant identification documents, tax information, or any supporting documents required.
4. Use clear and legible handwriting when filling out the form. If the form is digital, type the information in the provided fields accurately.
5. Double-check each filled-out section to ensure accuracy. Mistakes or missing information could lead to delays or rejections.
6. If there are any questions or uncertainties regarding a particular section, seek clarification from the appropriate authorities or consult a professional.
7. Sign and date the form where required. Ensure that the signature matches the one on your official documents.
8. Keep a copy of the filled-out form for your records. It is crucial to have a copy in case there are any discrepancies or further inquiries.

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The note original forms must refer to the original documentation required for a specific transaction or record.

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