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 24.

This Question has been intentionally Omitted from the QHIN Application. No action is needed from applicants on this question, please proceed to Question 25.

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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.

Form 2

QHIN Application

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 24.

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