Application Information
Application Name:
Application Owner:
Application Technical Contact:
Application Description:
Application Marketplace ID/Link:
ServiceNow Request | Distribution Status & Date | Internal Review Status & Date | ePHI Indicator | Target User Base |
---|---|---|---|---|
Current Issues
List current issues here. When an issue is resolved, document the resolution and date, and move the issue into the issue log.
Issue Log
Maintain a list of issues and their resolution.
Reapproval Conditions
Document the conditions under which the application would be subject to reapproval (e.g., collecting ePHI data when it did not previously).
Internal Review Status: complete or incomplete
Internal Distribution Request Date | Office of Technology Transfer Signoff | Legal Counsel Review | Marketing & Communications Review | Compliance & Regulatory Review | IT Security Review | Architecture Review |
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Collateral
Upload collateral as it is collected.
Approval Artifacts
Upload approval artifacts as they are collected.
- Completed IP Disclosure.
- Commercial Evaluation Report.
- Legal Counsel Review.
- Marketing and Communications Review.
- Compliance and Regulatory Review.
- IT Security Review.
- Architecture Review.
- App Store Submission Templates.
- Distribution Review Checklist.