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ONC Certification Page

Certified to 2015 Edition: “This Health IT Module is 2015 Edition compliant and has been certified by
an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of Health
and Human Services. This certification does not represent an endorsement by the U.S. Department of
Health and Human Services.”

Vendor/Developer Name: Shareable Forms 
Certified Health IT/EHR Name: Shareable FORMS
Certified Health IT/EHR Version: Shareable FORMS V2
Certificate ID: 
Certification Date: 2021-12-20
Criteria Certified: 170.315a5 Demographics, 170.315d1 Authentication, access, control and authorization, 170.315d3 Audit reports, 170.315d2 Auditable events and tamper-resistance, 170.315d4 Amendments, 170.315d5 Automatic access time-out, 170.315 d7 End-user device encryption, 170.315d12 Encrypted authentication credentials, 170.315d13 Multi-factor authentication, 170.315g4 Quality management system, 170.315d6 Emergency access, 170.315g3 Safety-enhanced design, 170.315g5 Accessibility-centered design

Clinical Quality Measures Certified: NONE

Additional software (relied upon software) required for certification: NONE

Pricing Disclosures: The additional types of costs an eligible provider would pay to implement ShareableFORMS V2 in order to attempt to meet meaningful use objectives and measures include a ShareableFORMS V2 solution implementation, setup, and training initial flat implementation fee; with an additional fee for hardware and for each custom integration.  Then a consumption-based transaction fee that includes maintenance,  support, and other professional services with additional fees, commensurate with the level of effort required, that may be charged for data retrieval and/or customized reporting requests that are above and beyond the contractual scope of services.

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