Name and Address of Partner: Symverta, LLC

16 White Pine Lane,

East Setauket NY, 11733

1.1 To comply with HIPAA and state standards in maintaining the confidentiality of protected health information, the above parties agree to enter into the following:

1.2 Each party will transmit and receive information either directly or indirectly through the encrypted Symverta portal. There are no additional costs for HIPAA encryption.

1.3 If a third party is utilized, once this agreement is executed, then the third party shall be responsible for the confidentiality of all protected health information. In any ancillary agreement, both parties agree that this agreement will supersede any language responsible for transmitting protected health information.

1.4 Each party shall be responsible for the security and operation of their own system and protected health information, including, but not limited to, all federal standards required under HIPAA, and it is agreed upon that neither party will be responsible for the other party’s system or failure to maintain confidentiality. Each party further agrees to indemnify the other party for any and all costs, including but not limited to legal expenses, ancillary expenses, or consequential damages, should the other party be found liable for a breach of integrity or confidentiality that is the fault of the offending party.

1.5 Both parties will mutually agree upon adopting an electronic signature standard

1.6 This document shall remain in effect until the Symverta agreement is terminated by either party.

1.9 This document shall remain in effect, and it is agreed to unless the failure is by an act of God and, therefore, beyond the control of either party.

Each party has read this agreement and agrees to enter into this chain of trust agreement effective on the above date.

Symverta is updating their policies and you are required to accept this new chain of trust agreement to continue using hte system.

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