EMV Attestation

Section 1

This page serves as a PCI Acknowledgement and Attestation. Please use the directions below as a starting point for the agreement.

  • Enter your pharmacy name in the name field
  • Enter an email address that you have easy access to
  • Press the "Process To Document" section to sign and download

Section 2

The attestation describes that you will have a Security Policy and Incident Response Plan – both are included here.

  • After signing an email will be sent to the address provided in "Section 1" to confirm your signature
  • After confirming the signature, another email will direct you to the sign document for review and download
  • Download the "Completed PDF"