Clinical Contract Instructions

The university must have an Affiliation Agreement with a particular agency before you can begin working there with a preceptor. The first step is to identify possible clinical agencies in your community that would be appropriate for the course. We encourage you to communicate with the nursing faculty member(s) who will be teaching the course as you identify potential agencies and preceptors. We can help you determine the suitability of an agency or preceptor for the specific clinical objectives of each course. Sometimes it may be necessary for faculty to make the initial contact with the agency on your behalf.

Establishing a new contract agreement can take up to three months. Therefore, if you want to use an agency with which the university does not have a contract, please the information below:

All fields marked with an asterisk (*) are required.

required text field

Legal name of the facility:*

required textarea field

Mailing address of the facility:*

Please include street address, city, state and zip code.

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Facility Telephone number:*

required text field

Facility Fax number:*

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Name of person authorized to sign the contract for the facility:*

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Title of person authorized to sign the contract for the facility:*

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Your Contact person:*

required email address field

Email address for Contact person:*

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Name of your Preceptor:*

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Name of Student Submitting Request:*

Link (required)

It is important that you follow up with Felicia to check on the progress and status of the contract. Do not assume that a contract will be automatically approved if the nursing program initiates a contract with a particular agency. Sometimes an agency requests changes to a contract, and this will take longer to be reviewed. In some rare cases, we have been unsuccessful at establishing a contract.

If you have any questions, please contact Becca Johnson at becca.johnson@angelo.edu.