CLINICAL TRAINING AFFILIATION AGREEMENTTraining Affiliation Agreement • August 21st, 2018
WHEREAS, the purpose of this AGREEMENT is to guide and direct the parties respecting their affiliation, working arrangements and agreements in furtherance thereof to provide high-quality clinical learning experiences for [Nurse Practitioner] students in the SCHOOL.
TRAINING AFFILIATION AGREEMENT BETWEENTraining Affiliation Agreement • January 24th, 2018
TRAINING AFFILIATION AGREEMENT BETWEENTraining Affiliation Agreement • January 24th, 2018
TRAINING AFFILIATION AGREEMENTTraining Affiliation Agreement • February 11th, 2020
TRAINING AFFILIATION AGREEMENTTraining Affiliation Agreement • April 2nd, 2019
This Training Affiliation Agreement is entered into as of the date of last signature below (“Effective Date”) by and between Oregon Health & Science University (“OHSU”), an Oregon statutory public corporation, and Klamath County Public Health (“CONTRACTING AGENCY”).
TRAINING AFFILIATION AGREEMENTTraining Affiliation Agreement • February 11th, 2020
FIELDWORK TRAINING AFFILIATION AGREEMENTTraining Affiliation Agreement • June 7th, 2012
TRAINING AFFILIATION AGREEMENTTraining Affiliation Agreement • March 10th, 2021
This Agreement made by and between [insert name & address here], and its professional staff as employees, agents and independent contractors, individually and collectively ("Affiliate"), and the Arizona Board of Regents acting on behalf of The University of Arizona, (College of Science, Department of Speech, Language and Hearing Sciences), pursuant to Arizona Revised Statutes Title 15, Chapter 13, Article 2, Section 1625.B.2 ("University"), collectively the “Parties.”
TRAINING AFFILIATION AGREEMENT (Updated 5/08/16)Training Affiliation Agreement • May 8th, 2016
WHEREAS, Yale University [hereinafter “Yale”], through its Department of Psychiatry, wishes to provide educational experiences to graduate students both in the Department and through its affiliated institutions; and
TRAINING AFFILIATION AGREEMENT BETWEENTraining Affiliation Agreement • January 24th, 2018
TRAINING AFFILIATION AGREEMENT REQUEST FORM (SOM)Training Affiliation Agreement • July 19th, 2018
AGREEMENT SUMMARY REQUEST DATE: DATE OF NEXT SCHEDULED ROTATION: TYPE:DOMESTIC INTERNATIONAL TRAINEE TYPE:CLINICAL PSYCH GME OTHER: NO. OF TRAINEES: INCOMING OUTGOING NEW RENEWAL AMENDMENT FREQUENCY OF USE: REGULAR ONE-TIMEFACILITY:HOSPITAL MEDICAL GROUP SINGLE PHYS AGREEMENT REQUIRED BY ACCREDITING ORG? YES NO IF YES, SPECIFY ORG: ACGMEOTHER: UCSF INFORMATION UCSF GME PROGRAMS ROTATING TO AFFILIATE SITES (SPECIFY, IF ANY): UCSF GME REQUESTOR CONTACT:NAME:ADDRESS:CAMPUS BOX:PHONE: FAX:EMAIL: TRAINEE DUTIES: CLINICAL RESEARCH (THE TRAINEE WILL HAVE NO PATIENT CONTACT OR PATIENT CARE DURING THE RESEARCH) PROVIDE BRIEF DESCRIPTION: AFFILIATE INFORMATION SITE NAME:MAILING ADDRESS CONTACT FOR CONTRACT DETAILSNAME: STREET: TITLE: CITY/STATE: EMAIL: ZIP: COUNTRY: PHONE: FAX: PHONE: FAX: MAILING ADDRESS: (IF SAME AS SITE MAILING ADDRESS, CHECK BOX) TRAINING LOCATION DETAILS(IF DIFFERENT THAN ABOVE SITE ADDRESS) SIGNATORY CONTACT DETAILS(IF DIFFERENT THAN ABOVE CONTRACT CONTACT) STREET: NA
TRAINING AFFILIATION AGREEMENT BETWEENTraining Affiliation Agreement • January 24th, 2018
FIELDWORK TRAINING AFFILIATION AGREEMENTTraining Affiliation Agreement • October 10th, 2017
TRAINING AFFILIATION AGREEMENT BETWEENTraining Affiliation Agreement • January 24th, 2018
