Awesome Gapps Business Associate Agreement

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You are requesting to get a Business Associate Agreement (BAA). As a reminder, a BAA is a contract addendum which governs the processing of personal data within the services and for compliance with the Health Insurance Portability and Accountability Act of 1996, as amended (“HIPAA Rules”). The BAA is included as part of Awesome Gapps' Terms of Service.
In order to process your request we need some information. This information will serve as a basis to customize the BAA so it is binding between you and us. When submitting this Form, you will receive an automatically generated BAA in an email asking you to approve it. Click on approve, log in with your Google account, sign the BAA and you then receive the final executed copy !
You can consult our BAA here: https://docs.google.com/document/d/e/2PACX-1vQqvhqXUt2cXYBxV8t994IPbYv6STB-xYAd9evL7rgYdDVb7BKAtPTCfHWqMoofKyT7Lyr087svZ5mY/pub?urp=gmail_link&gxids=7628

Your Company/Organization Legal Name *

Your First Name *

Your Last Name *

Your Title *

Your Email *

For the purposes of notification under Sections 2(g) and 2(j) of the BAA

Your Phone Number *

For the purposes of notification under Sections 2(g) and 2(j) of the BAA

Your Address *

For the purposes of notification under Sections 2(g) and 2(j) of the BAA

Your Organization Signatory Name *

Signatory Title *

Signatory Email *

BAA Effective Date *

YYYY

Awesome Gapps Services You are using *

Awesome Table

YAMM

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