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 31.

If you use a third-party technology vendor in connection with your Designated Network and such third-party vendor will have access to TEFCA Information, please provide a list of such vendors. If your Parent is providing the technology for the Designated Network, then Parent will be considered a third-party technology vendor for purposes of this question.

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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.

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