Covered Entity Contact Information Clause Samples
The Covered Entity Contact Information clause specifies the required contact details for the party designated as the Covered Entity in an agreement. This typically includes providing a name, address, phone number, and email address for official communications or notifications related to the contract. By clearly identifying how and where to reach the Covered Entity, this clause ensures that important information, such as notices of breach or requests for information, are properly directed and received, thereby reducing the risk of miscommunication or missed deadlines.
Covered Entity Contact Information. To direct communications to Covered Entity’s staff, the Business Associate shall initiate contact as indicated herein. The Covered Entity reserves the right to make changes to the contact information by giving written notice to the Business Associate. Contact Name: Title: Company: Address: Phone: Fax:
Covered Entity Contact Information. To direct communications to above-referenced Covered Entity’s staff, the Business Associate shall initiate contact as indicated herein. The Covered Entity reserves the right to make changes to the contact information by giving written notice to the Business Associate. DHS Program Manager: DHS Privacy Officer: c/o Office of Legal Counsel Department of Health Services ▇ ▇. ▇▇▇▇▇▇ Street Madison, WI 53707 608-266-5484
Covered Entity Contact Information. To direct communications to above referenced Covered Entity’s staff, the Business Associate shall initiate contact as indicated herein. The Covered Entity reserves the right to make changes to the contact information by giving written notice to the Business Associate. Fond du Lac County ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Director/Department of Social Services ▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Fond du Lac, WI 54935 920-929-3433 Fond du Lac County HIPAA Privacy & Security Officer/Director of Administration ▇▇▇ ▇. ▇▇▇▇ Street Fond du Lac, WI 54935 920-929-3156
Covered Entity Contact Information. To direct communications to above referenced Covered Entity’s staff, the Business Associate shall initiate contact as indicated herein. The Covered Entity reserves the right to make changes to the contact information by giving written notice to the Business Associate. Waukesha County Security Officer ▇▇▇▇ ▇▇▇▇▇▇▇▇ Dept. of Admin. Info. Tech. ▇▇▇-▇▇▇-▇▇▇▇ ▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ ▇▇▇ ▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇ CG53 Waukesha, WI 53188 Waukesha County Privacy Officer ▇▇▇▇ ▇▇▇▇▇▇ Corporation Counsel 262-548-7432 ▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ ▇▇▇ ▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇ AC 330 Waukesha, WI 53188 Waukesha County Health and Human Services Director ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇ ▇▇▇▇▇ If at any time PHI received from, or created or received by Business Associate on behalf of Covered Entity, is provided or made available by Business Associate to any of its Subcontractors, then Business Associate shall require each such Subcontractor to agree in writing to the same restrictions and conditions on the use or disclosure of PHI as are imposed on Business Associate by this Agreement and applicable law, including the HIPAA Rules. Business Associate shall ensure that all such Subcontractors that create, receive, maintain, or transmit PHI will implement reasonable and appropriate safeguards to protect such PHI.
Covered Entity Contact Information. To direct communications to above-referenced Covered Entity’s staff, the Business Associate shall initiate contact as indicated herein. The Covered Entity reserves the right to make changes to the contact information by giving written notice to the Business Associate. DHS Program Manager: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Department of Health Services ▇ ▇. ▇▇▇▇▇▇ Street Room B158 Madison, WI 53707 DHS Privacy Officer c/o Office of Legal Counsel Department of Health Services ▇ ▇. ▇▇▇▇▇▇ Street Madison, WI 53707 608-266-5484 DHS Security Officer Department of Health Services ▇ ▇. ▇▇▇▇▇▇ Street Madison, WI 53707 608-261-8310 In accordance with 45 CFR 164.502(e)(1) and 164.308(b), if applicable, the Business Associate shall ensure that any subcontractors that create, receive, maintain, or transmit Protected Health Information on behalf of the Business Associate agree to the same restrictions, conditions, and requirements that apply to the Business Associate with respect to such information.
Covered Entity Contact Information. To direct communications to above-referenced Covered Entity’s staff, the Business Associate shall initiate contact as indicated herein. The Covered Entity reserves the right to make changes to the contact information by giving written notice to the Business Associate. Covered Entity Program Manager: DHS Privacy Officer c/o Office of Legal Counsel Department of Health Services ▇ ▇. ▇▇▇▇▇▇ Street Madison, WI 53707 ▇▇▇-▇▇▇-▇▇▇▇ DHS Security Officer Department of Health Services ▇ ▇. ▇▇▇▇▇▇ Street Madison, WI 53707 ▇▇▇-▇▇▇-▇▇▇▇ 5. USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION BY SUBCONTRACTORS OF THE BUSINESS ASSOCIATE In accordance with 45 CFR 164.502(e)(1) and 164.308(b), if applicable, the Business Associate shall ensure that any subcontractors that create, receive, maintain, or transmit Protected Health Information on behalf of the Business Associate agree to the same restrictions, conditions, and requirements that apply to the Business Associate with respect to such information.
Covered Entity Contact Information. To direct communications to above-referenced Covered Entity’s staff, the Business Associate shall initiate contact as indicated herein. The Covered Entity reserves the right to make changes to the contact information by giving written notice to the Business Associate. Covered Entity Compliance Officer ▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇ ▇. ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Dept. Privacy Officer ▇▇▇▇ ▇▇▇▇▇ ▇▇▇ ▇. ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Covered Entity Security Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇. ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇
Covered Entity Contact Information. To direct communications to Covered Entity Privacy Officer, the Business Associate shall initiate contact as indicated here. Covered Entity reserves the right to make changes to the contact information below by giving written notice to Business Associate. These changes shall not require an amendment to this Agreement. Privacy Officer c/o: Office of Compliance CalOptima ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Email: ▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇.▇▇▇ Telephone: (▇▇▇) ▇▇▇-▇▇▇▇ (ask the operator to connect to Privacy Officer) [Add contact information for HCA Privacy Officer]
Covered Entity Contact Information. To direct communications to Covered Entity Privacy Officer, the Business Associate shall initiate contact as indicated here. Covered Entity reserves the right to make changes to the contact information below by giving written notice to Business Associate. These changes shall not require an amendment to this Agreement. Privacy Officer c/o: Office of Compliance CalOptima ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Email: ▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇.▇▇▇ Telephone: (▇▇▇) ▇▇▇-▇▇▇▇ (ask the operator to connect to Privacy Officer) ▇▇▇▇▇ ▇. ▇▇▇▇▇, LCSW, CHC, CHPC Chief Compliance Officer ▇▇▇ ▇. ▇▇▇ ▇▇, #▇▇▇ Santa Ana, CA 92701 Email: ▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇▇.▇▇▇ Telephone: (▇▇▇) ▇▇▇-▇▇▇▇