Form 1

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

Foreign Ownership Menu

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 3d.

Does any combination of Non-U.S. Person(s)s or Non-U.S. Entity(ies) have an aggregate Direct or Indirect Ownership Interest of 50% or greater in the Applicant?

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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.

Have a Question?

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.

Name of Person or Entity	Foreign Ownership Type	Percent of Ownership	Country of citizenship for a Non-U.S. Person or country in which the Non-U.S. Entity is organized	Actions

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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

Foreign Ownership Menu

Question 3d.

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