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This form attests to the completion of Culturally and Linguistically Appropriate Services training.

Molina Healthcare expects network practitioners to effectively deliver services to people of all cultures, races, ethnic backgrounds and religions, as well as individuals who speak a language other than English, persons with a disability, and other populations with unique needs, in a manner that recognizes, values, affirms and respects the worth of the individuals and protects and preserves the dignity of each. Training of employees and providers and quality monitoring are the cornerstones of respectful and responsive service delivery. For that reason, Molina Healthcare has integrated training on Culturally and Linguistically Appropriate Services (CLAS) concepts in the annual training for our participating provider network. We support and adhere to the National CLAS Standards in Health and Health Care as established by the U.S. Department of Health and Human Services.
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Providers may complete the Molina training if they do not have their own curriculum available or complete a separate CLAS training in accordance with the National CLAS Standards.
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Find the Molina CLAS training modules, and other resources and educational materials, on the Availity Essentials Provider Portal.
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By providing my information below, I attest that I have completed CLAS training.

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* 1. I am a Provider in

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* 2. I have received and reviewed the posted materials for the CLAS training, or I have completed my own CLAS 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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