HIPAA-Compliant Communication Software Evaluation Form
Please complete this form to evaluate communication software for use in healthcare-related settings. Do not submit any sensitive or health information.
Your Full Name
*
First Name
Last Name
Organization Name
*
Your Role or Title
*
Contact Email
*
example@example.com
Software or Vendor Being Evaluated
*
Primary Use Case or Workflow
*
Please Select
Internal staff communication
Patient-provider communication
Care coordination
Telehealth/virtual visits
Other
Key Communication Features Needed
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Secure messaging
Video conferencing
File sharing
Group chat
Mobile access
Other
Integration Requirements
*
EHR/EMR integration
Scheduling systems
Single sign-on (SSO)
Mobile device management
Other
Security and Privacy Priorities
*
End-to-end encryption
Access controls
Audit logging
Data retention policies
User authentication
Other
Overall Evaluation Notes or Recommendation
Submit
Should be Empty: