Request a Business Associate Agreement
For covered entities, business associates, and authorized representatives. Use this page to request review of a PatientTrac Business Associate Agreement or to route legal/security contacts to our team.
Do not submit PHI, patient names, medical record numbers, claim numbers, dates of service, or other patient-specific details through this public form.
When a BAA is needed
A BAA is typically needed when PatientTrac creates, receives, maintains, or transmits PHI for a HIPAA-regulated customer. A BAA is not a substitute for an order form, service agreement, implementation statement of work, security review, or customer-side compliance program.
What happens after submission
- We verify the requesting organization and relationship to PatientTrac.
- We confirm whether the proposed services involve PHI.
- We route the request to legal/security review.
- We provide a BAA workflow or appropriate next step.
- Execution of a BAA is not complete until signed by authorized representatives.