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Business Associate Agreement

Please fill out this form as completely as possible. It will be sent securely to our office.

Instructions

  1. Download and read the attached Business Associate Agreement in its entirety. It is also included at the bottom of this page.
  2. Sign the BAA by completing the form titled “Sign the Agreement” on this page.

Sign the Agreement

Add your name and signature to the Business Associate Agreement by completing this form.
This field is for validation purposes and should be left unchanged.

Fairhope Pediatrics Business Associate Agreement