BUSINESS ASSOCIATE AGREEMENT

This Business Associate Agreement ("Agreement") is entered into on _________, 20___, by and between:

Covered Entity: ______________________________________

and

Business Associate: Fiat Communications______________

Collectively referred to as the "Parties."

1. Purpose

The purpose of this Agreement is to establish the responsibilities of the Business Associate when creating, receiving, maintaining, transmitting, or using Protected Health Information ("PHI") while providing services to the Covered Entity. The Parties agree to comply with all applicable requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the HITECH Act, and any related federal regulations.

Fiat Communications will keep all patient information safe and secure.