NOTE: Step 1 below applies to IU School of Nursing staff and faculty only, as access is required.
Step 1: Find out if there is already an active agreement.
You have options to help you find out whether there is already an active agreement.
Box: There are copies of all agreements in Box. Agreements are listed alphabetically in the Affiliation Agreements folder. Find the agreement. Most agreements are effective for 3-4 years after the effective date. Look in "Term and Termination" to determine the expiration date. For example, if an agreement says it is active for 4 years and the effective date is 1/15/20, it will expire 1/15/24. There is also a summary of active agreements in Box. If you are IU SON staff or faculty and would like access to these files, please contact Teresa Abney tlabney@iu.edu.
Box Affiliation Agreements (Links to an external site.)
IUPUI Office of General Counsel:You can search the database of the IUPUI Office of General Counsel. However, this database only provides information about whether there is an existing agreement. It does not list the type of agreement or expiration date, and you cannot obtain a copy of the agreement via this resource. It is informational only.
IUPUI Office of General Counsel Affiliation Agreement Database
Step 2: Determine what type of agreement is appropriate.
Links to the various types of affiliation agreements are available on the web site of the IUPUI Office of General Counsel. The options and a brief description are as follows:
Master Affiliation Agreement Templates: Master agreements apply to all IUPUI schools and programs inside or outside of Indiana or national. Select the appropriate link to view/download the agreement.
- Master Affiliation Agreement Template for Facilities in Indiana only
- Master Affiliation Agreement Template for Facilities outside Indiana only
- Master Affiliation Agreement Template for Facilities with Multi-State Locations
Program-Specific Affiliation Agreement Templates: These agreements apply only to specific programs, e.g. Nursing at any IU campus. Click on the appropriate link below to view/download the agreement.
- Program-Specific Affiliation Agreement Template for Facilities in Indiana
- Program-Specific Affiliation Agreement Template for Facilities outside Indiana only
- Program-Specific Affiliation Agreement Template for Facilities with Multi-State Locations
- Student Teaching Affiliation Agreement Template (CAEP Accreditation) (Links to an external site.)
- Student Teaching Affiliation Agreement Template (Links to an external site.)
Students Doing Rotations at IU Affiliation Agreement Template: Use this agreement if you are accommodating a non-IU student at an IU affiliated campus. Click on the link below to view/download the agreement.
University-to-University: Click on the link below for an example of a template you would use if you were placing a student at another university.
University-to-University Agreement
Step 3: Submit Request
Affiliation Agreement Requests: Agencies can submit requests for new/renewal agreements, or faculty can submit requests on behalf of agencies, via a Qualtrics form. Click on the link below to access the survey form. Requests should be made at least three (3) months prior to desired effective date for standard agreements. If the agreement is non-standard or requires the use of a non-IU template, six (6) months lead time should be allowed. There is a link to email the Coordinator of Student Clinical Experiences with details of non-standard agreements.
Request for New/Renewal Affiliation Agreement (Links to an external site.)
Clinical Agency Update Form: Along with the request form, agencies (or faculty submitting) should submit a Clinical Agency Update form, which ensures that we have accurate information about the clinical site in our database. Click on the link below to access the form.
Clinical Agency Update Form (Links to an external site.)
Certificate of Insurance: Students are covered by malpractice insurance. Below is a link to our current (2019) Certificate of Insurance. Click on the link below to access the document. Agencies will be send a copy once they submit the request and Clinical Agency Update form. IU School of Nursing Certificate of Insurance
Step 4: Processing
Agreement Preparation:
Once the request is received, the Coordinator for Student Clinical Experiences (CoSCE) will send the agency a copy of the IUSON Certificate of Insurance and acknowledge receipt of the request.
Agency Approval:
The CoSCE will prepare the agreement and send it to the agency for signatures.
IUSON Approval:
Approval of IUSON administration is only required for master agreements.
IU Office of General Counsel Approval:
The CoSCE will forward the approved agreement to the IU Office of General Counsel for approval. The paralegal, Lisa Kilgore, will direct any questions to the CoSCE, who will communicate with appropriate parties. Once the agreement is finalized, the paralegal will return it to the CoSCE.
Fully Executed Agreement:
The CoSCE will email the fully executed agreement to the site and copy faculty and/or campus representatives as appropriate (IUB, IUPUC, IPFW).
Final Processing:
The CoSCE will upload the agreement to Box, place a copy in the agency's file, and update the Affiliation Agreement master summary document in Box.