Attachment B - Partnership Validation Form.pdf

This document is a Partner Validation Form for the Massachusetts Rural Health Transformation Program (RHTP), designed to confirm that partner organizations are aware of their identification as current partners in an applicant organization's RHTP Request for Application response. The form contains two primary sections: Section 1 requires the applicant organization to identify the partner organization, specify relevant RHTP Activity Areas, and provide a brief description of the partnership included in the application. Section 2 must be completed by the partner organization and requires the partner's contact information, including the partner organization name, contact person name and title, and email address. The partner representative must sign and date the form to acknowledge awareness of the partnership identification, confirm that the described relationship generally reflects the current partnership, and understand that the acknowledgement does not create contractual obligations or guarantee funding or participation in RHTP activities.

The form explicitly states that completion does not constitute a contractual commitment, funding agreement, or guarantee of future participation. Electronic signatures are acceptable for execution of the document. This validation form serves as an administrative confirmation mechanism within the RHTP application process and does not establish binding legal obligations between the applicant organization and the partner organization. The form structure allows for multiple partner validations to be submitted as part of a single RHTP application.