Clinical Instructional Agreement

Using an Agency’s Instructional Agreement

If the agency has its own Clinical Instructional Agreement (sometimes called an “Affiliation Agreement”), the student should request that the agency scan the agreement as soon as possible to Benjamin Hickerson at [email protected]. Because the agency’s agreement must be approved by the UNCG Attorney, it can take several weeks for the agreement to be finalized.

• Clinical Instructional Agreement (Form B) (PDF)
  required for all students completing an Internship at a clinical site.  This form is NOT REQUIRED for Practicum students.
• Non-Clinical Instructional Agreement (Form A) (PDF)
  Required for all students completing an Internship at a non-clinical site.  This form is NOT REQUIRED for Practicum students.

Students should seek information regarding the agreement early, so there is enough time for processing before the internship begins.

Using the UNCG Instructional Agreement

If a clinical agency does not have their own agreement, they can use the UNCG Clinical Instructional Agreement .

PROCESS FOR USING THE UNCG CLINICAL INSTRUCTIONAL AGREEMENT:

1. The CTR student sends the agency the link to the UNCG Clinical Instructional Agreement with instructions print, sign where required, and scan to Benjamin Hickerson at [email protected].

2. Once the agency has signed and scanned the agreement to Benjamin Hickerson, she will obtain the HHS Dean’s signature, then send a copy of the completed agreement to the agency.  At that point, the agreement is complete.

If the agency has issues with parts of the agreement, they should make notations on the agreement and scan a copy to Benjamin Hickerson at [email protected].  The agreement will then be routed to the University Attorney who may or may not sign with his/her approval for the agencies notations on the agreement.  At times (but very rarely) the agency and university cannot come to terms with the agreement, and the student has to find another internship site.

For this reason, it is very important that the Instructional Agreement be dealt with early, so there will be plenty of time to find another internship if an agreement cannot be completed.