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 14.

Please describe your organizational structure and identify the individuals who will support the Designated Network, including how these individuals will work with the Designated Network Governance Body and their tenure with the organization.

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Please describe your organizational structure and identify the individuals who will support the Designated Network, including how these individuals will work with the Designated Network Governance Body and their tenure with the organization.
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