The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

KFjyuwy4xdGt2i4ySUu9JGLpiBn5iZRencyQrIkHyJSRzm5ws7NB5jmLHKr2s9kg7G2s

Program Duplication Form

Returning?

A A A

The Centers for Medicare & Medicaid Services has awarded funding to the Kentucky Consortium for Accountable Health Communities to support our efforts in connecting patients to community services. As a condition of this award, we need to ensure that our funding is not being used to provide the same service to a patient that they are already receiving through another state or federal program.

We will need your help to identify programs in the community that are also assisting Medicare or Medicaid patients to connect to programs that help with things like housing, transportation, food, utilities, or personal safety. If you have any questions about this form, please contact KC-AHC@uky.edu.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.