Healthcare Certification Readiness Assessment

🏢

Business Information

LegitScript requires full transparency about your business history and ownership structure.

📋 LegitScript Questions 1–3 · Standards 3, 8

💡

Why this matters: LegitScript verifies ownership to check for prior discipline history and ensure all principals are operating legally across all affiliated entities.

Legal Business Name *

Primary Contact Name *

Contact Email *

Contact Phone

Website URL *

Short description of your business model *

Describe what your organization does, who you serve, and how services are delivered.

How long has your company been in business? *

Was ownership recently transferred?

Yes No

List all owners, principals, officers, and directors *

Include full name and title for each person. Example: Jane Smith — CEO, John Doe — CMO

Organization type *

Telemedicine / Telehealth Provider Pharmacy (online or brick-and-mortar) Digital Health Platform Medical Spa Pharmaceutical Manufacturer Other Healthcare Merchant

🪪

Licensure & Registration

LegitScript requires complete licensing documentation for every jurisdiction where you operate.

📋 LegitScript Question 4 · Standard 1: Licensure & Business Registration

⚠️

Most common rejection reason: Incomplete or missing licensure documentation. LegitScript requires licenses for both where medications are prescribed AND where patients are located.

Primary state of business registration *

How many states do you currently operate in? *

Do you have active business licenses in ALL states where you operate? *

Yes — fully licensed in all operating states Partially — some states may be missing No — need to identify gaps Unsure — have not fully audited

Do all providers hold active licenses in every state where they treat patients? *

Yes — all providers licensed in all practice states Partially — some gaps exist No Unsure

What types of licenses does your organization hold? *

Individual medical licenses (MD/DO/NP/PA) Pharmacy license(s) DEA registration for controlled substances State business registration / entity license Interstate Medical Licensure Compact (IMLC) NPI (National Provider Identifier) Medicare / Medicaid enrollment (PECOS)

Are all licenses current and not expired, suspended, or on probation?

Yes, all current Some issues exist Not fully verified

Additional licensure notes (optional)

🌐

Website & Digital Presence

LegitScript reviews your live website as part of the certification process.

📋 LegitScript Questions 5–8 · Standards 5, 6, 8

Primary website URL being submitted for certification *

List ALL domains owned and operated by your business and principals *

💡 LegitScript requires an exhaustive list of all domains. Missing domains can result in denial.

Is your primary website currently complete and fully operational? *

Yes — fully complete with all content live Partially complete — some sections still in development Under construction / placeholder content present

Does your website have a patient or user login / account area? *

💡 LegitScript will need login credentials to review gated areas of your site.

Yes No

Does your business offer a mobile app? *

Yes No

Is your website secured with HTTPS throughout?

Yes, fully HTTPS Partially No

Does your advertising accurately represent your services without misleading claims?

Yes, fully accurate Some claims may need review Known issues exist

🤝

Services, Partners & Prescribing

LegitScript evaluates your telemedicine compliance, affiliate relationships, and controlled substance procedures.

📋 LegitScript Questions 9–14 · Standards 2, 4, 7

Does your business offer telemedicine services? *

Yes No

For each state where you provide telemedicine, do you comply with jurisdiction-specific laws for: *

Establishing patient-practitioner relationship (initial visit requirements) Patient identification verification Documented patient consent for telehealth services Online prescribing laws per jurisdiction Medical records retention and HIPAA compliance Not fully documented / needs review

Do you have business affiliates with shared ownership or formal/informal business relationships? *

💡 This includes co-owned businesses, partner pharmacies, provider networks, marketing partners, and supplying wholesalers. LegitScript requires full disclosure of all affiliates.

Yes — all affiliates are operating legally and compliant Yes — but compliance status of some affiliates is unknown No affiliates or partner organizations

Are your partner pharmacies LegitScript-certified or accredited by a recognized body?

Yes No N/A — no partner pharmacies Unsure

Have you had any audits or inspections in the last 5 years? *

Board of Pharmacy, medical boards, FDA, DEA, or other regulatory bodies.

Yes — audit(s) completed with no adverse findings Yes — audit(s) resulted in findings or corrective actions No audits or inspections

Does your business prescribe, dispense, administer, distribute, or manufacture controlled substances? *

Yes No

If yes — do you have documented procedures to address and minimize controlled substance diversion?

Yes — written policies and procedures in place Informally addressed but not documented No documented procedures N/A — no controlled substances

💊

Pharmacy Operations

Complete this section if your organization operates as a pharmacy or compounds medications. Skip if not applicable.

📋 LegitScript Questions 11, 15–17 · Standards 1, 2, 7

Does your business operate as a pharmacy? *

Yes No — skip this section

Does your pharmacy compound prescription medications?

Yes No N/A

How can prescribers submit new prescriptions to your pharmacy?

How can patients submit new prescription orders?

How do patients receive their prescription medications?

Mail / shipping In-store pickup Sent to local pharmacy N/A

Are your pharmacy operations FDA 503A/503B compliant (if compounding)?

Yes No / Not assessed N/A — not compounding

⚖️

Prior Discipline & Legal History

LegitScript requires full disclosure of any legal, regulatory, or disciplinary history in the last 5–10 years.

📋 LegitScript Question 18 · Standard 3: Prior Discipline and History

⚠️

Critical disclosure requirement: This applies to the company, ALL principals, owners, key staff, and any associated medical or pharmacy practitioners. Failure to disclose is grounds for immediate denial.

In the last 5 years, has your company been subject to any of the following? *

Lawsuit or civil litigation License revocation, suspension, restriction, or probation Warning letter or reprimand from a regulatory agency FDA Form 483 or consent agreement Cease and desist order Criminal conviction (any principal or key staff) Payment industry fine (Visa VIRP, Mastercard BRAM, or similar ≥$2,000) None of the above

Have any principals or key staff been subject to discipline by a medical or pharmacy board in the last 10 years? *

Yes No Not fully verified

If any discipline history exists — have you prepared documentation of the facts and remediation steps taken?

Yes, documented No N/A — no history

Are there any ongoing investigations, litigation, or regulatory actions currently in progress?

Yes No Not certain

Additional context or notes (optional)

Any additional compliance concerns or information for your advisor?

🏆

Your Certification Readiness Report

Based on your responses, here is your LegitScript Healthcare Certification readiness assessment.

Certification Readiness Score

—/100

Calculating...

📋 OneVi Internal Review Panel

This section is visible to your compliance advisor. Review the submission, add notes, and prepare the consultation.

—Readiness Score

—Critical Gaps

—High Priority

—Standards at Risk

⚖️ LegitScript Standards Alignment 9 Standards

✅

Next step: A OneVi compliance advisor will review your submission and contact you within 1–3 business days to walk through your certification readiness and recommended remediation plan. A copy of this report will be sent to your email automatically upon submission.

Healthcare Certification
Readiness Assessment

Business Information

Licensure & Registration

Website & Digital Presence

Services, Partners & Prescribing

Pharmacy Operations

Prior Discipline & Legal History

Your Certification Readiness Report

📋 OneVi Internal Review Panel

Assessment Submitted!

What Happens Next

Healthcare CertificationReadiness Assessment

Business Information

Licensure & Registration

Website & Digital Presence

Services, Partners & Prescribing

Pharmacy Operations

Prior Discipline & Legal History

Your Certification Readiness Report

📋 OneVi Internal Review Panel

Assessment Submitted!

What Happens Next

Healthcare Certification
Readiness Assessment