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Form 1

Means To Demonstrate U.S. Ownership and Control of a Qualified Health Information Network (QHIN) Standard Operating Procedure (SOP) Questionnaire

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Question 1  Question 2  Question 3a  Question 3b  Question 3c  Question 3d  Question 4  Question 5  Question 6  Question 7  Question 8  Question 9  Question 10  Attestation of Completion 

Question 4.

Where is the Applicant’s principal place of business?

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