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This form is an attestation of completion of Cultural Competency training.

Molina is committed to improving health equity as a culturally competent organization. We support and adhere to the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care as established by the Office of Minority Health. We also maintain compliance with accreditation standards focused on health equity.
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Molina Healthcare offers an annual Cultural Competency training to our participating provider network to effectively meet the unique and diverse needs of all members.
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Providers may complete the Molina training if they do not have their own curriculum available or complete a separate Cultural Competency training in accordance with federal requirements and CLAS guidelines.
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Find the Molina Cultural Competency training modules on the
Culturally and Linguistically Appropriate Resources/Disability Resources page on the Health Care
Professionals site under the Health Resources tab at MolinaHealthcare.com.
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By providing my information below, I attest that I have completed Cultural Competency training.

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* 2. I have received and reviewed the posted materials for the Cultural Competency training, or I have completed my own Cultural Competency training course in compliance with federal, state, and CLAS guidelines.

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* 3. Group Tax Identification Number (TIN):

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* 4. Clinic/Office Name:

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* 5. Clinic/Office Address:

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* 7. Comments/Suggestions:

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