3rd Party Risk Assessment


Third Party Risk Assessment

In order to meet privacy regulations, AccelHealth must have the following information about the
applications that are used to create, store, view, maintain or transmit our data. We appreciate your help
in returning this form to us as quickly as possible

The information you provide will be reviewed by AccelHealth’s IT Department, Compliance Department
and/or the IT Security Department. Your responses are confidential.

If the answer to the above question is “No,” please identify who completed this form.