THIS Business Associate Agreement (this “Agreement”) dated as of __________________ (the “Effective Date”) is by and between Proton Technologies AG, a corporation with offices at Route de la Galaise 32, 1228 Plan-les-Ouates Geneva, Switzerland (“Business Associate”), and ________________________________________ a corporation, with offices at ____________________________________ (“Covered Entity”).


NOW, THEREFORE, the parties, in consideration of the mutual agreements herein contained and for other good and valuable consideration, the receipt and adequacy acknowledged, do hereby agree as follows:


Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in the Privacy Rule.

1. Obligations and Activities of Business Associate

2. Permitted Uses and Disclosures by Business Associate

Except as otherwise limited in this Agreement, Business Associate may only use or disclose Protected Health Information to perform functions, activities, or services for, or on behalf of, Covered Entity as specified in this Business Associate Agreement, provided that such use or disclosure would not violate the HIPAA Rules if done by Covered Entity or the minimum necessary policies and procedures of the Covered Entity.

3. Specific Use and Disclosure Provisions

Business Associate may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 164.502(j)(1).

4. Obligations of Covered Entity

5. Permissible Requests by Covered Entity

Covered Entity shall not request Business Associate to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Rules if done by Covered Entity.

6. Term and Termination

7. Miscellaneous

[Date and Signatures]

(Note: this document is only for informational purposes and does not constitute an offer. If you would like to obtain a signed copy of this agreement, please contact us at: