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Office of the State Longer Care Ombudsman Conflict of Interest Screen *Please Print Clearly×Last nameFirst nameRegionPlease check all that applies: Initial screenAnnual screen with no change (approval
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The initial screen is a preliminary assessment form that organizations must complete to evaluate their compliance with applicable regulations and requirements.
Organizations that fall under specific regulatory frameworks or guidelines are required to file the initial screen.
To fill out the initial screen, organizations must gather relevant information and complete the form accurately, ensuring all required fields are filled in accordance with the provided instructions.
The purpose of the initial screen is to establish baseline compliance and identify areas needing attention or improvement before the full compliance process begins.
The initial screen requires organizations to report information such as organizational details, regulatory compliance status, and any previous assessments or findings.
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