Electronic HIPAA Business Associate Agreement Form

MGIS has created this electronic form to simplify the process of submitting HIPAA-regulated Business Associate Agreements. Details of this agreement and how to complete the process are found below.

Instructions for Completing HIPAA Business Associate Agreement

  1. Click here and read the agreement.
  2. Complete the form below to confirm that you have read and accept the terms of the Agreement on behalf of the individual, partnership, professional corporation, hospital or other entity on whose behalf this Agreement is made.
  3. Click "I Accept" and print the agreement for your records.
  4. You are finished - It's that simple!

By executing this Agreement electronically, you represent and warrant that you are authorized to enter into and execute this Agreement on behalf of the individual, partnership, professional corporation, hospital, or other entity on whose behalf this Agreement is made.



Validate your electronic signature by completing the remainder of this form.

I have read and agree to the terms of this agreement.

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