Welcome to the Nexpring Health Third Party Distributor Due Diligence Form.

This is to be completed by the Nexpring Health business sponsor prior to entering into a contract/relationship. The business sponsor is the Nexpring Health employee who is recommending that we evaluate a relationship with the third party.

Thank you for taking the time to complete this questionnaire on behalf of Nexpring Health. The purpose of this form is to gather accurate and comprehensive information to the best of your ability. Please answer each question as thoroughly as possible.

After you complete this form, you will receive an email to complete a separate Business Justification Form, which provides additional Third Party details to the Compliance team. Completion of this form is necessary in order to proceed with the vetting of the proposed third party.

Your responses will help ensure a clear and informed understanding of the subject matter. If any clarification is needed, please do not hesitate to reach out to legal@nexpringhealth.com.

We appreciate your time and effort in providing honest and accurate answers to the best of your ability.