2024-2025 SendaRide Care Partner Training and Policy Attestations Form

The following form must be used to attest that you have read and understood the following required policies:

Code of Conduct
Zero Tolerance
General Compliance (Compliance Plan)

AND

That you have completed the following required trainings:

HIPAA
Fraud, Waste. and Abuse (FWA)
Handling Bloodborne Pathogens
Flu/Covid Prevention
Diversity/Cultural Competency and Civil Rights
Sexual Harassment Prevention
Transporting Vulnerable Populations + Dealing with Escalated Situations

If you have any questions or concerns about the trainings or policies, generally, or how they apply to your work for SendaRide, specifically, please do not hesitate to reach out to SendaRide's Compliance Team @ ethicshelp@sendaride.com.

Please note: Completing the above-listed trainings and policy reviews is a requirement of your contract with SendaRide. Truthfully attesting to completion of these trainings and policy reviews is a requirement of your contract with SendaRide. Failure to complete these trainings and policy reviews or failure to accurately and truthfully attest to completion will result in your inability to contract with SendaRide and/or a termination of your contract with SendaRide, as applicable

Thank you!

Care Partner Name

Please enter your full name, as it appears on the Drivers License you submitted to SendaRide

Care Partner Email Address

Please enter the email address we have on file for you.

Date of Submission

Please enter today's date - the date you are submitting this form.

mm/dd/yyyy

Code of Conduct Attestation

This is where you will attest that you have completed a thorough review of SendaRide's Code of Conduct Policy.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have read and understood the policy

Code of Conduct Attestation Date

Please enter the date on which you completed your review of the Code of Conduct Policy.

mm/dd/yyyy

Zero Tolerance Attestation

This is where you will attest that you have completed a thorough review of SendaRide's Zero Tolerance Policy.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have read and understood the policy

Zero Tolerance Attestation Date

Please enter the date on which you completed your review of the Zero Tolerance Policy.

mm/dd/yyyy

Compliance Plan Attestation

This where you will attest that you have completed a thorough review of SendaRide's Compliance Plan

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have read and understood the policy

Compliance Plan Attestation Date

Please enter the date on which you completed your review of the Compliance Plan Policy.

mm/dd/yyyy

HIPAA Training Attestation

This is where you will attest that you have completed the provided training materials on HIPAA Compliance

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have reviewed the training materials provided in their entirety and I understand them and how they apply to the work performed as a CP for SendaRide

HIPAA Training Date

Please enter the date on which you completed the training on HIPAA Compliance.

mm/dd/yyyy

FWA Training Attestation

This where you will attest that you have completed the provided training materials on FWA Prevention and Compliance.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have reviewed the training materials provided in their entirety and I understand them and how they apply to the work performed as a CP for SendaRide

FWA Training Date

Please enter the date on which you completed the training on FWA Prevention and Compliance

mm/dd/yyyy

Bloodborne Pathogens Training

This where you will attest that you have completed the provided training materials on Handling Bloodborne Pathogens.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have reviewed the training materials provided in their entirety and I understand them and how they apply to the work performed as a CP for SendaRide

Bloodborne Pathogens Training Date

Please enter the date on which you completed the training on Handling Bloodborne Pathogens.

mm/dd/yyyy

Flu/Covid Training Attestation

This where you will attest that you have completed the provided training materials on Preventing Flu/Covid Transmission.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have reviewed the training materials provided in their entirety and I understand them and how they apply to the work performed as a CP for SendaRide

Flu/Covid Training Date

Please enter the date on which you completed the training on Preventing Flu/Covid Transmissions.

Diversity/Civil Rights Training Attestation

This where you will attest that you have completed the provided training materials on Diversity, Cultural Competence, and Civil Rights.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have reviewed the training materials provided in their entirety and I understand them and how they apply to the work performed as a CP for SendaRide

Diversity/Civil Rights Training Date

Please enter the date on which you completed the training on Diversity, Cultural Competence, and Civil Rights.

mm/dd/yyyy

Sexual Harassment Prevention Training Attestation

This where you will attest that you have completed the provided training materials on Sexual Harassment Prevention.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have reviewed the training materials provided in their entirety and I understand them and how they apply to the work performed as a CP for SendaRide

Sexual Harassment Prevention Training Date

Please enter the date on which you completed the training on Sexual Harassment Prevention.

mm/dd/yyyy

Transporting Vulnerable Populations and Handling Escalated Situations

This where you will attest that you have completed the provided training materials on Transporting Vulnerable Populations and Handling Escalated Situations.

Your answer will be recorded for your file, to prove compliance with SendaRide's contracting requirements.

I have reviewed the training materials provided in their entirety and I understand them and how they apply to the work performed as a CP for SendaRide

Transporting Vulnerable Populations and Handling Escalated Situations Training Date

Please enter the date on which you completed the training on Transporting Vulnerable Populations and Handling Escalated Situations.

mm/dd/yyyy

Confirmation - Signature

Please enter your name once more to attest and confirm that the answers and dates provided in this form are correct and accurate, and that you, the individual named above and below and to whom this record will be attributed, is the same person who completed this form.

Falsely or inaccurately completing this form will result in your inability to contract with SendaRide and/or a termination of your contract with SendaRide, as applicable.

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