Form 2

QHIN Application

Part V - QHIN Privacy and Security Requirements

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 41.

Applicant must submit a detailed summary of Applicant organization’s HIPAA security risk analysis consistent with §164.308(a)(1)(ii)(A).

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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.