Form 2

QHIN Application

Part IV – Organizational Infrastructure and Legal Authority
The questions in this Part correspond to Part 4, Section I.4 of the QHIN Onboarding & Designation SOP.

Part I – Basic Applicant Information

Part II – Organizational Requirements

Part III – Exchange of Required Information and Ability to Perform Functions of a QHIN

Part IV – Organizational Infrastructure and Legal Authority

Part V – QHIN Privacy and Security Requirements

Part VI – Project Plan

Part VII - Background References

Part VIII - Attestation

Question 18.

Please describe how often the Designated Network Governance Body will meet.

"*" indicates required fields

This field is hidden when viewing the form

Drop files here or
Accepted file types: xls, xlsx, pdf, doc, docx, Max. file size: 128 MB.

    Have a Question?

    If you have a question at any time during the application process please feel free to contact the RCE team. We'll be happy to assist you.

    What can we help you find?

    Stay Connected

    Complete the form below and join our mailing list