Guidelines for the Creation of a New Affiliation Agreement
- Regional campus will contact Medical Student Affairs via msaffil@iupui.edu to request the current template of the Clinical Affiliation Agreement and identify the hospital/institution with whom an affiliation is being sought.
- Hospital/Institution should consult with their legal department.
- If the hospital/institution legal department wants to make any changes to the template, they should contact John Keller and Melissa Titus (msaffil@iupui.edu) at IUSM for further assistance. Note: changes made to the template will slow the approval process by several weeks.
- Once final language is approved, the hospital/institution should sign three (3) copies and return to John Keller (msaffil@iupui.edu) at IUSM.
- IUSM will route the document for official signatures and return an original to theregional campus and to the hospital/institution.
- IUSM will monitor expiration dates and contact hospitals/institutions when updates are required.


