Applicants must include the following information in an application for ONC-ACB status and submit it to the National Coordinator for the application to be considered complete.
(a) The type of authorization sought pursuant to Sec. 170.510. For authorization to perform EHR Module certification, applicants must indicate the specific type(s) of EHR Module(s) they seek authorization to certify. If qualified, applicants will only be granted authorization to certify the type(s) of EHR Module(s) for which they seek authorization.
(b) General identifying, information including:
(1) Name, address, city, state, zip code, and Web site of applicant; and
(2) Designation of an authorized representative, including name, title, phone number, and e-mail address of the person who will serve as the applicant's point of contact.
(c) Documentation that confirms that the applicant has been accredited by the ONC-AA.
(d) An agreement, properly executed by the applicant's authorized representative, that it will adhere to the Principles of Proper Conduct for ONC-ACBs.