Business Associate Agreement AddendumBusiness Associate Agreement Addendum • November 19th, 2019
Facility’s Name (“Facility”): ABC Facility Address: 123 Main Street, Ellicott City, MD 21043 Legal Structure: &RUSRUDWLRQ Owner’s Name: (In the event accreditation is granted, the entity that owns and operates the Facility) John Doe Owner’s Main Business Address: 123 Main Street, Ellicott City, MD 21043 Owner’s Representative Name & Title: (Should be the person for day-to-day contact and does not need to be the signee of the Agreement.) Jane Doe, Medical Director Private (non-governmental) Facility? Yes No Governmental Facility? Yes No Federal Tax ID: 123456789
BUSINESS ASSOCIATE AGREEMENT ADDENDUMBusiness Associate Agreement Addendum • June 25th, 2024 • Alaska
and between the Bristol Bay Area Health Corporation (“BBAHC”) and (“Contractor”) (individually, a “Party” and, collectively, the “Parties”).
GENERAL CONDITIONS OF PURCHASE BUSINESS ASSOCIATE AGREEMENT ADDENDUM EBusiness Associate Agreement Addendum • January 18th, 2022 • Rhode Island
Except as otherwise provided in this Business Associate Agreement Addendum, Health Management Associates (hereinafter referred to as “Business Associate”), may use, access or disclose Protected Health Information to perform functions, activities or services for or on behalf of the State of Rhode Island, Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (hereinafter referred to as the “Covered Entity”), as specified herein and the attached Agreement between the Business Associate and the Covered Entity (hereinafter referred to as “the Agreement”), which this addendum supplements and is made part of, provided such use, access, or disclosure does not violate the Health Insurance Portability and Accountability Act (HIPAA), 42 USC 1320d et seq., and its implementing regulations including, but not limited to, 45 CFR, parts 160, 162 and 164, hereinafter referred to as the Privacy and Security Rules and patient confidentiality regulations, and the requirements of th
Business Associate Agreement AddendumBusiness Associate Agreement Addendum • November 10th, 2020
This Business Associate Agreement Addendum (“Addendum”) is entered into by and between the party identified below ("Customer") and Proofpoint, Inc., with an address at 925 W. Maude Avenue, Sunnyvale, California 94085 (“Proofpoint”) (each, individually, a “Party” and both, collectively, the “Parties”). This Addendum is made a part of, and incorporated into, either: (1) the Proofpoint General Terms and Conditions and applicable Product Exhibit(s),
Business Associate Agreement AddendumBusiness Associate Agreement Addendum • September 30th, 2020
Facility’s Name (“Facility”): Zest Northwest Address: 511 Spicy Enchilda Terrace, Vancouver, BC, 88941 Canadia Legal Structure: Other (specify below) check check Owner’s Name: (In the event accreditation is granted, the entity that owns and operates the Facility) aaa Owner’s Main Business Address: bbb Owner’s Representative Name & Title: (Should be the person for day-to-day contact and does not need to be the signee of the Agreement.) ccc, ddd Private (non-governmental) Facility? Yes No Governmental Facility? Yes No Federal Tax ID: 22-2201231
