Clincial Instructional Agreement
Some healthcare agencies require a legal contract (Clincial Affiliation Agreement) between UNCG and the agency when offering practicum or internships to students. Students should inquire early as to whether or not this agreement is needed by the agency, and if so, whether or not the agency has its own form.
IF THE AGENCY REQUIRES AN AGREEMENT, THE STUDENT CANNOT BEGIN COUNTING PRACTICUM OR INTERNSHIP HOURS UNTIL THE AGREEMENT HAS BEEN FINALIZED.
Using the Agencies Agreement
If the agency has its own Clinical Affiliation Agreement, the student should request that the agency supervisor send the Clinical Affiliation Agreement AS SOON AS POSSIBLE to Amy Chandler, Administrative Assistant, 208 Ferguson Bldg, 524 Highland Ave, Greensboro, NC 27402, or by email to firstname.lastname@example.org.
Because the agency's agreement must be approved by the UNCG Attorney, it could take months for the agreement to be finalized. Students should seek information regarding the agreement early, so that enough time is allowed for processing before time for the practicum or internship to begin.
Using the UNCG Agreement
If a Clinical Affiliation Agreement is required by the agency but the agency does not have their own form, The UNCG Clincial Instructional Agreement can be used.
Instructions for submitting the UNCG Clinical Instructional Agreement
1. The student sends the agency the link to the UNCG Clinical Instructional Agreement with instructions to print out 2 copies, sign, and send back to the CTR Department.
2. The agency signs the agreements and sends the 2 copies with original signatures back to the CTR Department, or the agency makes notations on the agreement and sends the 2 copies with original signatures to the CTR Department. (Be sure that the agency sends 2 copies of the form. One with original signatures will be for the agency, one with original signatures will be for the CTR Department)
3. If no notations are made by the agency, the UNCG Attorney signs the agreement.
If the agency has made notations on the UNCG agreement, the UNCG Attorney either approves the changes or notifies the agency that it cannot agree to the agencies notations.
4. If approved, the CTR Department sends one of the two copies back to the agency with all required signatures.
Once the signed agreement has come back to the CTR Department from the UNCG Attorney, the agreement is complete and the student can begin counting practicum or internship hours.