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Initiate a New or Renew an Existing Affiliation Agreement

Submit the form below to initiate a new affiliation agreement with a clinical site or to renew an existing affiliation agreement through Academic Services.  Check the Online Affiliation Agreement Search Page before submitting this form to see if we currently have an agreement with a clinical site.

Academic Services is responsible for establishing and maintaining agreements with clinical sites for graduate and undergraduate clinical placements.  Per AS Memorandum 21, this form must be submitted by a clinical site coordinator or SoN faculty member.