Business Associate Agreement Form

A document to be used with a person or entity not affiliated with UW-Madison that performs or assists in performing, for or on behalf of any unit in the UW-Madison Health Care Component, business support functions/services that involve the use of Protected Health Information.

A health care provider that assists in providing treatment to patients is NOT considered a Business Associate.

For more information on HIPAA and for the most current Business Associate Agreement templates, please refer to the Office of Compliance HIPAA Privacy and Security Policies & Forms page.