Before you begin, please read the following instructions carefully.
Before beginning either of the below forms, be sure that you have completed the following:
If you have not completed the above steps, you are on this page too early in your onboarding journey.
Do not proceed with ANY submissions for any of the forms on this page. Submissions before appropriate steps may result in an incomplete submission and subsequent denial of your application as outlined in the QHIN Onboarding & Designation SOP.
Make sure you have your Submission Token (Submission ID) ready on hand. This is a private key and should not be shared with anyone outside of your organization. If you suspect a breach of your key, please inform the RCE immediately and you will be provided a new key to begin all submissions over.
Below you’ll find two form links:
Note: Submission of the Foreign Ownership Questionnaire is recommended prior to beginning your QHIN Application. It may be completed at any time prior to beginning your QHIN Application OR during completion of your QHIN Application. You MUST NOT submit the final attestation question (Question 47) of the QHIN Application until the Foreign Ownership Questionnaire and all other QHIN Application questions have been submitted.
Note: After submission of each question, an email confirmation that the respective question has been received by the RCE will be sent to your primary contact for QHIN onboarding, as identified in your submission of intent to apply for QHIN Designation. It is important to keep these confirmation emails for your records as you will want to keep track of what/which questions have been submitted to date.
