Search

Guidelines for the Creation/Renewal of Affiliation Agreements

Procedure for New Affiliation Agreements

  1. Campus of Influence Affiliations Site Controller contacts Statewide Affiliations Manager (SAM) at msaffil@iupui.edu to request a new agreement via paper or online request form.
  2. SAM sends request to Undergraduate Medical Education Clerkship Manager for review and approval as qualifying site
  3. Once approved, SAM sends official email with attached documents to Facility Contact.
  4. Facility Contact reviews and approves, sending (2) originals to SAM via regular/priority mail. If changes are necessary SAM brokers negotiations until completed.
  5. SAM routes documents to MSA Dean and then on to Legal Counsel for ED Dean and Counsel signatures. SAM returns original to Facility Contact

Procedure for Renewing Affiliation Agreements

  1. SAM sends request to Undergraduate Medical Education Clerkship Manager to verify site still in use or qualifying six months prior to agreement termination.
  2. Once approved by UME, SAM sends official email with attached documents to Facility Contact on file using msaffil@iupui.edu account.
  3. Facility Contact reviews and approves, sending (2) originals to SAM via US/Priority mail. If changes are necessary SAM brokers negotiations until completed. SAM routes documents to MSA Dean and then on Legal Counsel for ED Dean and Counsel signatures. SAM returns original to Facility Contact.
 
 

635 N Barnhill Dr | Indianapolis, IN 46202 | Ph: (317) 274-1970 | Fax: (317) 274-4309