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 Student and Academic Services.

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

Request Information
Affiliation Agreement Information
AA Contact/Signee Information