Business Associates Agreement

Fill in the following form to build your own FREE Business Associates Agreement (B.A.A.) you can use to have all your Business Associates sign.
  • The full name of the person representing the company (covered entity) sending the business associate agreement.
  • The title of the person representing the company (covered entity) who will be signing the agreement
  • The company name of the business associate. If the business associate is a sole proprietor enter their full legal first and last name
  • The persons full legal name who will be signing the agreement as the business associate
  • The title of the person signing the business associate agreement.
  • Email address of the business associate.

eSign B.A.A.

When you are a member of Medipliance, we make getting your Business Associates Agreements as easy to manage as filling out this form. From our members area, when you submit this form we automatically send our B.A.A. to your Business Associate for an electronic signature.

BAAs Stored in the cloud

Once your B.A.A. signs the agreement it is automatically returned to your portal so that you can sign it. All of your B.A.A's are safely stored in your portal so you are always up to date.