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USE BLACK INK ONLY.PLEASE PRINT. For address and/or primary care physician changes call (518) 6413700, 18007772273, or visit www.cdphp.com Note: You cannot purchase an individual plan if you are enrolled

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What is note you cannot purchase?

Note you cannot purchase is a document that specifies the items or services that are prohibited from being bought.

Who is required to file note you cannot purchase?

Vendors and individuals purchasing goods or services on behalf of an organization are required to file note you cannot purchase.

How to fill out note you cannot purchase?

Note you cannot purchase can be filled out by listing the prohibited items or services and providing a justification for why they cannot be purchased.

What is the purpose of note you cannot purchase?

The purpose of note you cannot purchase is to ensure compliance with regulations, prevent unethical purchases, and protect the organization from legal and financial risks.

What information must be reported on note you cannot purchase?

The information that must be reported on note you cannot purchase includes the description of the prohibited items or services, the reason for their prohibition, and the name of the person authorizing the note.

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