School:

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Student Name:

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NATIONAL PATIENT SAFETY GOALS 2015

Acknowledgement of Receipt
By signing below, I acknowledge that I have received the 2014 National
Patient Safety Goals Orientation Training Packet. I understand it is my
responsibility to familiarize myself with the information given and will read
through all the material contained within.

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Print Name
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Student Signature

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Date

AIDET POST -TEST