Dear Electronic Signature Recipient,
You have been designated as your company’s authorized signatory. If you are not the authorized signatory for your company, please forward this email to the appropriate signatory.
Please click on the button below to review and electronically sign the BAA referenced in this email.
BUSINESS ASSOCIATE AGREEMENT
Pursuant to the Master Subscription Agreement, Zendesk provides the Service to Subscriber, including the provision of HIPAA Enabled Account(s). By executing this BAA, Zendesk consents to the Subscriber’s collection of Protected Health Information (PHI) through the Service. The purpose of this BAA is to reflect the parties’ agreement with regard to the protection of the PHI pursuant to the Health Insurance Portability and Accountability Act (HIPAA). All capitalized terms not defined herein shall have the meaning set forth in the BAA.
HOW TO EXECUTE THIS BAA
To complete this BAA, the Subscriber must complete the following information and sign on the last page:
Subscriber: full legal name of Subscriber
By: signature of authorized signatory
Name: name of authorized signatory
Title: title of authorized signatory
Date: date of signature
Zendesk Account Numbers: account number(s) for HIPAA Enabled Account(s)
HOW THIS BAA APPLIES:
If the Subscriber entity signing this BAA is a party to the MSA, this BAA forms part of the MSA. In such case, the Zendesk entity that is a party to the MSA is a party to this BAA.
If the Subscriber entity signing this BAA has executed a Service Order Form with Zendesk or its Affiliate pursuant to the MSA, but is not itself a party to the MSA, this BAA is an addendum to that Service Order Form and applicable renewal Service Order Forms, and the Zendesk entity that is a party to such Service Order Form is a party to this BAA.
If the Subscriber entity signing this BAA is neither a party to a Service Order Form nor the MSA, this BAA is not valid and is not legally binding. Such Subscriber entity should request that the Subscriber entity who is a party to the MSA execute this BAA.
If the Subscriber entity signing the BAA is not a party to a Service Order Form or MSA directly with Zendesk, but is instead a customer of Zendesk via an authorized reseller of Zendesk services and subject to the Reseller Subscription Services Agreement, this BAA is valid and legally binding.
You will have the option to download the BAA for review prior to completing the execution process. To do so, simply click on the “Download” icon located top center of the page (see image below). Once you have completed the execution process, you will automatically receive a fully signed copy of the BAA for your files. Upon completion of the validly completed BAA, this BAA will become legally binding.
For additional information about HIPAA compliance, please visit: https://support.zendesk.com/hc/en-us/articles/210178838-Advanced-Security-Data-at-Rest-Encryption-Enhanced-Disaster-Recovery-and-HIPAA-Compliance-Enterprise-Add-on-.
Should you have any questions, please contact email@example.com.