Download:
pdf |
pdf Non-visible Questions
Label
Why
not?
PDF Name
(step)
Location
Medical
Malpractice
Payer
Attestation (1)
Below the
Yes and No
radio
buttons
Response
Input Item
Text Entry
Visibility Trigger
Other
The field is displayed
if the user selects the
No radio button
State Changes
Label
PDF Name
Item Type
Trigger
OMB Number: 09150126 Expiration Date:
mm/dd/yyyy
Medical
Malpractice
Payer
Attestation
Modal
When the user selects the link the modal
is displayed with the public burden
statement content.
| File Type | application/pdf |
| File Title | Medical Malpractice Payer Attestation |
| Subject | NPDB attestation |
| Author | Health Resources and Services Administration |
| File Modified | 2020-11-19 |
| File Created | 2020-07-29 |