Business Associate Agreement - Henry Ford Health System 2026

1. Click ‘Get Form’ to open the Business Associate Agreement in the editor.
2. Begin by entering the Effective Date at the top of the form. This includes the month, day, and year.
3. Fill in your company name as the Business Associate in the designated field.
4. Review each section carefully, especially obligations regarding protected health information (PHI). Ensure you understand your responsibilities under HIPAA.
5. Complete any additional fields as required, such as contact information for notifications and reporting breaches.
6. Once all sections are filled out accurately, sign and date the agreement at the bottom of the form.
7. Submit the completed agreement via email or fax to the Information Privacy & Security Office as instructed.

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