What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.

At JotForm, we want to make sure that you’re getting the online form builder help that you need. Our friendly customer support team is available 24/7.

We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you’d like help immediately, feel free to search for a similar question, or submit your question or concern.


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    Need a business associate agreement

    Asked by tmcoxdds on May 17, 2016 at 09:04 AM

    I have a business associate agreement that needs to be signed by someone at Jotform. Who can I fax or email it to?

    Thanks,

    Jenny Cox

    agreement business associate associate agreement
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    JotForm Support

    Answered by Welvin on May 17, 2016 at 11:17 AM

    I'm sorry, but can you please let us know why we need to sign one? What is the purpose? Is that a requirement of your company? Anyways, I have forwarded this thread to our team manager. She'll be able to answer this matter for you.

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    JotForm Support Manager

    Answered by Jeanette on May 17, 2016 at 11:21 AM

    Hello Jenny

    Please send the agreement to support@jotform.com so I can check and see if this is something we can sign.

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    Answered by tmcoxdds on May 17, 2016 at 11:44 AM
    The business associate agreement is required by HIPAA regulations to protect patients' private information. We are required to have a business associate agreements with all vendors we do business with who have access to patient informantion. I will email the agreement.
    Thank you,
    Jenny Cox
    Cox and Manegold Dentistry
    9215 Cincinnati Columbus Road
    West Chester, OH 45069
    (513) 777-5513
    CONFIDENTIALITY STATEMENT
    This e-mail transmission is intended only for the addressee(s) named above. This email message and any attachment from Cox and Manegold Dentistry, Dr. Thomas Cox or Dr. David Manegold to this e-mail message may contain information that is confidential, proprietary, privileged, legally privileged and/or exempt from disclosure under applicable law. If you are not the intended recipient, please accept this as notice that any disclosure, copying, distribution or use of the information contained in this transmission is strictly prohibited. We reserve the right, to the extent and under certain circumstances permitted by applicable law, to retain, monitor, and intercept e-mail messages to and from its systems. Any views or opinions expressed in this e-mail are those of the sender. Although this transmission and any attachment are believed to be free of any virus or other defect that might affect any computer system into which it is received and opened, it is the responsibility of the recipient to ensure that it is virus free and no responsibility is accepted, as applicable, for any loss or damage arising in any way from its use. If you have received this e-mail in error from Cox and Manegold Dentistry, please immediately contact the sender by return e-mail or destroy the material in its entirety, whether electronic or hard copy format.
    ...
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    JotForm Support

    Answered by Charlie on May 17, 2016 at 01:31 PM

    Thank you for updating us. 

    Please do note that we are not HIPAA compliant. But you can check my manager's post about JotForm and HIPAA on this thread post: http://www.jotform.com/answers/333046-is-JotForm-HIPAA-Compliant 

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    Answered by tmcoxdds on May 17, 2016 at 02:44 PM
    In order for us to be HIPAA compliant, we must have the agreement signed or we cannot use Jotform.
    Jenny Cox
    Cox and Manegold Dentistry
    9215 Cincinnati Columbus Road
    West Chester, OH 45069
    (513) 777-5513
    CONFIDENTIALITY STATEMENT
    This e-mail transmission is intended only for the addressee(s) named above. This email message and any attachment from Cox and Manegold Dentistry, Dr. Thomas Cox or Dr. David Manegold to this e-mail message may contain information that is confidential, proprietary, privileged, legally privileged and/or exempt from disclosure under applicable law. If you are not the intended recipient, please accept this as notice that any disclosure, copying, distribution or use of the information contained in this transmission is strictly prohibited. We reserve the right, to the extent and under certain circumstances permitted by applicable law, to retain, monitor, and intercept e-mail messages to and from its systems. Any views or opinions expressed in this e-mail are those of the sender. Although this transmission and any attachment are believed to be free of any virus or other defect that might affect any computer system into which it is received and opened, it is the responsibility of the recipient to ensure that it is virus free and no responsibility is accepted, as applicable, for any loss or damage arising in any way from its use. If you have received this e-mail in error from Cox and Manegold Dentistry, please immediately contact the sender by return e-mail or destroy the material in its entirety, whether electronic or hard copy format.
    ...
  • Profile Image

    Answered by victor on May 17, 2016 at 04:15 PM

    Please email us at support@jotform.com, our manager will look into all your requirements and she will reply to you directly.

    Have a great day.