Compliance Hotline Form 1Identity Preference2Personal Details (optional)3Description of Issue 4Review Notice & Submit Would you like to remain anonymous?(Required) YES, remain anonymous No, I don't mind sharing my identity Personal DetailsName First Last PhoneEmail Department Description of IssueTitle of Issue(Required)Detailed Comments(Required) PPOA is committed to conducting its business ethically and in compliance with all applicable state and federal laws, regulations, guidance and PPOA internal policies and procedures. Workforce members are expected to report any potential identified issues or questions associated with PPOA’s Code of Conduct, policies and procedures, Compliance Plan, fraudulent activities, and laws and regulations be reported to the Compliance Department immediately. Reporters may choose to remain anonymous (to the extent possible and allowed by law) and know that all reports will be handled in a confidential manner. This form represents one of many ways to report a compliance issue. Workforce members may also report issues: 1) To their immediate supervisor, department director, or administrative team members who will report the matter to the Compliance Officer; 2) Directly to the Compliance Officer or the compliance department via email ComplianceOfficer@PhysicianPasrtnersOA.com; 3) Using the Compliance Hotline at 844-999-2073 or internal extension x2091; or 4) A PPOA compliance-related or process-related routine audit or risk assessment.