This guide discusses some important topics about an acknowledgment receipt and gives useful acknowledgment receipt examples. âś“ A completed Application Form must have all fields filled out.âś“ Only the single signature page is required. The recipient's signature, printed name and date of signing must be included on the receipt. My question is does it matter if she signed the certified return receipt? Each contract employee and complete an updated Receipt Acknowledgement documenting the redistribution. Genesee Medical Group - Acknowledgement of Receipt of Notice of Privacy Practices (HIPAA), v.