Client Registration & Intake

Start Assessment & Create Your Account

Complete your health system's preliminary assessment intake below and establish your client portal credentials to track your audit in real time.

🔒 HIPAA-Compliant Session⏱ ~5 min📞 24hr Response🛡️ 256-bit AES Encryption

No obligationZero patient PHI collectedCustom-scoped quote within 48hrs

1. Organization & Leadership Contact

Identify your institution and the primary audit liaison.

Organization Name *

Organization Type *

Organization Address *Physical or headquarters address (pre-fills your Master Services Agreement and official audit filings).

Your Full Name *

Leadership Role / Title *

Professional Work Email *This will also serve as your login username.

Phone Number *

Tailor the assessment to your health system's infrastructure scale.

Audit Tier or Service Desired *

Number of Providers (MDs, NPs, PAs) *

Annual Operating Budget *

Primary EHR System

EHR Implementation Year

HIPAA Compliance Last Reviewed *

Help us prepare tailored governance deliverables before the discovery session.

Current AI or Automation Tools in Use *

Key Stakeholders & Compliance Leads *

Key Success Criteria *

Set your portal credentials to securely view your audit progress, checklist, and findings.

Portal Access

Portal Username / Login IDDefaults to your professional email above if left blank.

Create Portal Password (min 8 chars) *

Confirm Portal Password *

Your account will be provisioned immediately and our health IT compliance team will reach out within 24 hours.

Already registered? Sign In to Portal

By signing up you agree to be contacted by DFEAL LLC regarding your health IT assessment. No patient PHI collected. CAGE: 15RT3 · UEI: G1XCPA2ANMC3.