Dental Business Associate Agreement Tracking

Tracks business associate agreements with dental labs, imaging centers, and software vendors that handle PHI.

Agreement Overview

• Vendor / Business Associate Name
  Enter the legal name of the vendor, lab, imaging center, or software provider.
• Type of Service
• Service Description
  Briefly describe the service provided and why PHI is involved.
• Internal Relationship Owner
  Name or team responsible for managing the vendor relationship.
• Agreement Status

PHI Access and Scope

• Does this vendor create, receive, maintain, or transmit PHI on our behalf?
• PHI Access Scope
• Minimum Necessary Notes
  Describe any data minimization controls, such as limiting access to only the PHI needed for the service.
• Is a BAA required for this relationship?

Agreement Dates and Status

• Effective Date
  Date the agreement became effective, if signed.
• Signature Date
• Expiration Date
• Renewal Notice Date
  Date to begin renewal follow-up before expiration.
• Compliance Status

Documentation and Audit Trail

• Signed BAA File
  Upload the executed agreement or related amendment.
• Vendor Security Documentation
  Optional supporting documentation such as security attestations or privacy addenda.
• Review Notes
  Add audit trail notes, exceptions, follow-up items, or approval comments.
• Next Review Date
  Date for the next compliance review or renewal check.