Affiliation Agreement Submission

Purpose

All clinical affiliation agreements should be submitted through this site for Provost signature, regardless of whether additional OGC review is required. Clinical affiliation agreements receive additional processing through the Office of the General Counsel (OGC) to look for potential legal issues when the clinical affiliation agreement is (a) on a facility's template or (b) the facility has suggested edits to TWU's Standard Form Master Affiliation Agreement Template.

Only the legality of a proposed agreement is reviewed by the OGC. Individual departments are responsible for determining if their faculty and students can abide by the technical requirements outlined within the agreement. A department's Dean, Director, or Fieldwork Coordinator should review ALL affiliation agreements and make any proposed edits to the technical requirements before the department submits the agreement to the OGC for review. Submission of an affiliation agreement through this site will serve as attestation to the Provost that that the submitting department's Dean, Director, or Fieldwork Coordinator has reveiwed the agreement and agrees to the technical requirements outlined in the agreement. If, in reviewing the agreement before submission, the Dean, Director, or Fieldwork Coordinator notices an issue with the technical requirements, he or she should use Track Changes in Word to document the issue and propose new language that is acceptable to the department before submtting the agreement to OGC for review. OGC will then add any additional edits that may be necessary to the legal terms of the agreement before returning the agreement back to the department to obtain approval by the facility.

Getting Started

The OGC does not initiate contact with any facility about beginning the clinical affiliation agreement process. Individual TWU departments must initiate contact with the desired facility and determine if the facility will accept the TWU Standard Form Master Affiliation Agreement Template (SFA) template for their department/program or if the facility prefers to use its own agreement template.

If the facility is amenable to using TWU's SFA, please send them a copy of TWU's Standard Form Master Affiliation Agreement, located in the list of files to the right of this text on your screen. 

If the facility prefers to use its own template, please request that the facility send you an electronic “Word” version of the template rather than a "pdf" version. It is much easier, faster, and clearer to make necessary edits to the proposed agreement in Word. Please do not convert a pdf version of the facility's agreement into a Word version to submit to OGC. Doing so creates a formatting nightmare during the review process, and OGC will return the agreement to the submitter to address the formatting issues before reviewing the agreement. If a facility is hesitant to provide a Word version of their agreement, please assure the facility that TWU will use the Track Changes feature in Word to ensure that the facility can clearly identify and review any changes suggested by TWU.

Before submitting an agreement that was created using a facility's template or using a TWU Standard Form Affiliation Agreement that has been edited by the facility to the OGC for review, the agreement must first be reviewed by the program's Dean, Director or Fieldwork Coordinator to check for technical requirements of the agreement. When submitting an agreement to the OGC that is on a facility's template, you must also submit a Facility Affiliation Agreement Approval Form with the Department or Program's Dean, Director or Fieldwork Coordinator's signature indicating that the Dean, Director or Fieldwork Coordinator has read the agreement and is willing to comply with its technical terms. The Affiliation Agreement Approval Form form can be found in the list of files to the right of this article on your screen.

Prior to Requesting OGC Review:

The following Checklist is used by the Office of General Counsel (OGC) to determine whether an agreement is ready for legal sufficiency review. Please ensure that the following items are completed before submitting an affiliation agreement for legal sufficiency review or Provost signature. If the following items are not completed correctly, the agreement will be returned to you to fix the issue before OGC will review the agreement for legal sufficiency and/or obtain the Provost’s signature.

  • The Texas Woman’s University name should be spelled correctly and located somewhere on the first page of the agreement.
  • The name of the Hospital/Facility should be somewhere on the first page of the agreement, likely in the same paragraph as TWU’s name.
  • The Effective Date is the date that the agreement starts. The Effective date should be filled in if there is a blank to fill in a particular date somewhere in the agreement, typically on the first page. Alternatively, the agreement may contain a statement saying that the agreement is effective as of the date it is signed by both parties. Either is acceptable.
  • The Term Length explains how long the agreement lasts. The Term Length should be stated somewhere in the agreement. It may be listed as a number of years, a specific date range, or may have only a specified termination date. Any of these options are acceptable.
  • The Notice Information contains information about who at TWU should be notified by the Hospital/Facility if the Hospital/Facility needs to notify the University about something pertaining to the agreement or a student participating at the Hospital/Facility. The Notice Information should be filled in completely and accurately. There may or may not be a notice information section in the agreement; if there is not one, you do not need to add one. If there is one, make sure that the notice information for TWU is someone in your department with the authority to respond to the notice or lists the information for the Provost’s office.
  • The Signature Line should state the correct name and title of the designated TWU signatory. This should always include the current Provost’s name and title, unless another signatory is designated by the Provost.
  • Fill in any other blanks with the requested information and check any boxes that may need to be checked.
  • The submission must be a Word document or PDF, depending on whether you are submitting a TWU standard form template or the Hospital/Facility’s template.
    • If the Hospital/Facility has agreed to use TWU’s Standard Form template, and has not suggested edits to the template, and you have already obtained the signature of the Hospital/Facility, then you may submit a PDF of the affiliation agreement.
    • If you are submitting an affiliation agreement that is on the Hospital/Facility’s template, or if the Hospital/Facility has agreed to use TWU’s template, but has suggested edits to the template, then you must submit a Word document.  PDF’s will be sent back. PDFs that have been converted to Word, but retain formatting issues created by the conversion will be sent back.
  • Submissions must include all referenced exhibits, attachments, schedules or other documents in one document file.

Using TWU's Standard Form Affiliation Agreement Template

If a facility agrees to the terms in TWU's SFA, they (or you) should fill in all highlighted information and remove the highlighting. The facility's authorized representative should sign the agreement and return a copy to you. You should then forward the agreement to the OGC for final signature by following the "Submission" instructions below. Once the Provost has signed the agreement, a fully executed copy will be returned to you. Save a copy of the fully executed agreement for your department's records and forward a fully executed copy back to the facility.

If the facility does not want to agree to the terms in the SFA, they may make any proposed edits using the Track Changes feature in Microsoft Word, which should already be activated within the template. The facility should return a copy of the SFA with their proposed edits to you, which you will then submit to the OGC for review by following the "Submission" instructions below. The OGC will review the facility's suggested edits to the agreement, approve, deny or respond using the Track Changes feature, and return the agreement to you. You will then forward the SFA back to the facility so they may review TWU's responses to their proposed edits. This process will continue until TWU and the facility agree on mutually acceptable terms. 

Submission

When you are ready to submit an affiliation agreement to the OGC for review and/or Provost signature, scroll to the top of this screen and click on the top grey box to the right of this text that says "Request Service". Fill out all of the applicable information in the form that pops up. Click on the "?" buttons in any field to read more information about how to fill in that section of the form. At the end of the form, there is a section called "Attachment". Be sure to upload the Word version of the affiliation agreement you would like reviewed here, if you are submitting an agreement that is not a TWU SFA or if the facility has proposed edits to the TWU SFA. Additionally, upload any applicable Affiliation Agreement Routing Form.

If a facility prefers to receive hard copies of signed agreements, indicate how many must be returned to the facility. Please make a note of this under "Additional Information" when requesting service. Any other notes you may want OGC to consider when reviewing the agreement should also be included in the section called "Additional Information"

Attestation Forms

Sometimes, a facility requests that TWU sign an attestation form, which indicates TWU's assurance that an appropriate background check has been performed on a clinical student before the facility will allow the student to begin clinical work at the facility. Often, the facilities that request signed attestation forms from TWU provide those forms for an appropriate authority in your department to sign. Attestation forms provided by a facility should always be attached to and submitted with a request for affiliation agreement review. Sometimes a facility will accept or prefers to use TWU's attestation forms. TWU's Standard Attestation Form (SAF) can be found in the list of files to the right of this text on your screen.  You may use this Standard Attestation Form without seeking approval/signature from the OGC.

Support

Contact the Office of General Counsel at 940-898-3250 or 81-3250.

Who Can Use It

Faculty
Staff

Cost

None 

Links List:
https://www.twu.edu/general-counsel/legal-services/affiliation-agreement-procedure/