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Clinical Site Affiliation Request Form St. Davids School of Nursing, Texas State University Note: The contact for the affiliation agreement must be authorized to enter into contracts on behalf of
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How to fill out clinical site affiliation request
How to fill out clinical site affiliation request
01
Step 1: Obtain the clinical site affiliation request form from your clinical coordinator.
02
Step 2: Fill out all the necessary information on the form, such as your personal details, the name and address of the clinical site, and the requested affiliation period.
03
Step 3: Attach any required documents to the form, such as proof of liability insurance coverage or immunization records.
04
Step 4: Review the completed form for accuracy and completeness.
05
Step 5: Submit the form to your clinical coordinator for review and approval.
06
Step 6: If the form is approved, your clinical coordinator will forward it to the appropriate department or institution for further processing.
07
Step 7: Follow up with your clinical coordinator or the designated department to ensure the request is properly processed and confirmed.
Who needs clinical site affiliation request?
01
Students or healthcare professionals who are seeking to complete clinical rotations or placements at a specific clinical site.
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What is clinical site affiliation request?
Clinical site affiliation request is a formal request to establish a partnership or agreement between a healthcare facility or institution and a clinical training program, typically for the purpose of providing hands-on training to students.
Who is required to file clinical site affiliation request?
Clinical site affiliation request is typically filed by the institution or program seeking to establish a partnership with a healthcare facility or institution for clinical training purposes.
How to fill out clinical site affiliation request?
To fill out a clinical site affiliation request, the institution or program must typically provide details about the program, the type of training needed, the desired partnership terms, and any other relevant information requested by the healthcare facility or institution.
What is the purpose of clinical site affiliation request?
The purpose of a clinical site affiliation request is to establish a formal partnership or agreement between a healthcare facility or institution and a clinical training program for the purpose of providing hands-on training to students.
What information must be reported on clinical site affiliation request?
The information reported on a clinical site affiliation request typically includes details about the program, the type of training needed, the desired partnership terms, and any other relevant information requested by the healthcare facility or institution.
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