Form preview

Get the Free Business Associate Agreement Template (HIPAA) - WordPDF - eForms

Get Form
Privacy & Security Incident Report Form for Media Business Associates (BA's) are required to report all security incidents and all impermissible uses or disclosures of protected health information
We are not affiliated with any brand or entity on this form
4,4
98,753 Reviews
4,5
11,210 Reviews
4,6
715 Reviews
4,6
789 Reviews

Get, Create, Make and Sign business associate agreement template

Edit
Edit your business associate agreement template form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your business associate agreement template form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing business associate agreement template online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use the professional PDF editor, follow these steps:
1
Sign into your account. In case you're new, it's time to start your free trial.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit business associate agreement template. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Save your file. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.
With pdfFiller, it's always easy to work with documents. Check it out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
Learn more about security & compliance
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out business associate agreement template

Illustration

How to fill out business associate agreement template

01
Step 1: Gather all the necessary information and documentation needed to fill out the business associate agreement template.
02
Step 2: Begin by entering the names and contact information for both the covered entity and the business associate.
03
Step 3: Specify the effective date of the agreement and the duration of the agreement.
04
Step 4: Outline the permitted uses and disclosures of protected health information (PHI) by the business associate.
05
Step 5: Include provisions for safeguarding PHI and complying with HIPAA regulations.
06
Step 6: Specify the responsibilities and obligations of both parties regarding the handling of PHI.
07
Step 7: Include any additional terms and conditions or provisions that are relevant to the agreement.
08
Step 8: Review the completed agreement to ensure accuracy and compliance.
09
Step 9: Have both parties sign and date the agreement.
10
Step 10: Keep a copy of the fully executed agreement for record-keeping purposes.

Who needs business associate agreement template?

01
Any covered entity or healthcare provider that shares protected health information (PHI) with a business associate needs a business associate agreement template. This includes hospitals, doctors' offices, health insurance companies, and any other entities that handle PHI on behalf of a covered entity.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.6
Satisfied
36 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

In your inbox, you may use pdfFiller's add-on for Gmail to generate, modify, fill out, and eSign your business associate agreement template and any other papers you receive, all without leaving the program. Install pdfFiller for Gmail from the Google Workspace Marketplace by visiting this link. Take away the need for time-consuming procedures and handle your papers and eSignatures with ease.
Once you are ready to share your business associate agreement template, you can easily send it to others and get the eSigned document back just as quickly. Share your PDF by email, fax, text message, or USPS mail, or notarize it online. You can do all of this without ever leaving your account.
You may do so effortlessly with pdfFiller's iOS and Android apps, which are available in the Apple Store and Google Play Store, respectively. You may also obtain the program from our website: https://edit-pdf-ios-android.pdffiller.com/. Open the application, sign in, and begin editing business associate agreement template right away.
A business associate agreement template is a legal document that outlines the responsibilities and obligations between a covered entity and its business associate when handling protected health information.
Covered entities and their business associates are required to have a business associate agreement in place.
The business associate agreement template should be filled out by specifying the parties involved, outlining the permitted uses and disclosures of protected health information, detailing each party's obligations regarding the protection of PHI, and including any other relevant information.
The purpose of a business associate agreement template is to ensure that protected health information is properly safeguarded and that both parties understand their responsibilities when handling PHI.
The business associate agreement template should include information such as the names of the covered entity and business associate, the permitted uses and disclosures of PHI, the safeguards in place to protect PHI, and the procedures for reporting breaches.
Fill out your business associate agreement template online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview

Business Associate Agreement Template is not the form you're looking for?Search for another form here.

Related Features

Tack Name in the Swimming Pool Maintenance Contract Template with ease
Tack Name in the Attendance Certificate with ease
Bold Comment in the Case Study Proposal Template with ease
Bold Comment in the Personal Medical History with ease
Bold Comment in the Child Medical History with ease

Relevant keywords

2022 impermissible reoccurrence nonbreach privacymedica medica subcontractor mitigation disclosures mitigated bas unintended misdirected applicable revisions inappropriately miscellaneous corrective entities disclosed forwarded attachments phi disclosure

Related Forms

Form preview
ptosb20pct kr form
Doc code: pph.pct.652 pto/sb/20pct-kr (07-12) approved for use through 01/31/2015. omb 0651-0058 u.s. patent and
Fill Now
Form preview
PTO/SB/57
This form is used to request an ex parte reexamination of a patent, allowing a
Fill Now
Form preview
Patent Prosecution Highway Pilot Program
Este programa piloto está diseñado para permitir a un solicitante cuyas reclamaciones se determinen como
Fill Now
Form preview
ss 4 fillable form
Pto/sb/20sg (05-10) document description: petition to make special under patent pros approved for use through
Fill Now
Form preview
PTO/SB/20PCT-RU
Petition to make special under pct-patent pros hwy. this request is for participation in the
Fill Now
Form preview
Checklist for a Petition to Recognize a Relationship as a Marriage - u
Checklist for a petition to recognize a relationship as a marriage you must complete a
Fill Now
Form preview
Application for Submission Section III - WORD
Office of adult educationpersonnel file checklistemployee name: date of hire: employee/orientation recordapplication and/or resumedegree
Fill Now
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.