Human Health Facility Licensee Application Form

Data Use License Agreement
By downloading this data (hereafter called "HINs"), I
*
(hereinafter referred to as the Licensee Organization) hereby agree that I am licensing from the Health Industry Business Communications Council (hereinafter referred to as HIBCC or the Licensor) the use of these HINs for a period of one year for a license fee as calculated as a consequence of this download. I further agree to the following terms:

HINs and any compilation of HINs remain the sole property of HIBCC. Licensee will take no action to infringe on the rights of the Licensor therein.

1. Licensee acknowledges that the Data constitutes valuable copyrighted and proprietary information of Licensor, covered by the Copyright Registrations #TX-8-748-740, #TX-6-589-387, and #TX-5-522-923. Licensee agrees not to sell or release data to any other individual, association, firm, parent or subsidiary organization, or other entity whatsoever, except as permitted by Licensor. The HIBCC Authorized Licensees list can be found at: here

2. If the Licensee is a data reselling organization Licensee agrees to use the HINs strictly for internal uses, and is prohibited from selling or otherwise distributing or disclosing HINs to any third party, including customers or clients of Licensee, without prior written consent of Licensor.

3. This Agreement shall take effect upon completion of the download of HIN data.

4. The obligation of confidence and nondisclosures assumed by Licensee hereunder shall not apply to: a) Information which at the time of disclosure is in the public domain; or b) Information which thereafter lawfully becomes a part of the public domain other than through disclosure by Licensee; or c) Information known to Licensee prior to licensors’ disclosures to Licensee; or d) Information which is lawfully disclosed to Licensee by a third party not under an obligation of confidentiality to licensor with respect to said information.

Having read the above, and having understood the terms and conditions of the Agreement, Licensee agrees to assume full responsibility for compliance with this Agreement. Any breach of this Agreement or any term there in will subject Licensee to any and all injunctive relief and legal and equitable remedies available to the Licensor.
Name of Licensee Organization*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Name*
First Last
Title
Signature*
Date
Date Format: MM slash DD slash YYYY
Do you accept the terms of the Data Use License Agreement? To download HINS, you must accept this agreement.
- Yes

*Important Note for International Credit Cards

If you are paying with a Non-United States/Canada credit card, you must use the PDF version of the application, available for download here.

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Data Use License Agreement

Organizational Information

Shipping Information

Application Categories & Fees ***

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