College of Health and Human Services

Academic Affiliation Agreements

Agreement request portal

• Students are only permitted to be placed for experiential learning experiences with off-campus sites/organizations if there is a current, valid academic affiliation agreement in place.
• Please be aware that the process to secure a new agreement can take anywhere from 1-2 weeks up to 6+ months.  Requests should be made as early as possible in order to avoid potential delays in start dates.
• Faculty, affiliate site personnel, or students can request a new academic affiliation agreement using the CHHS- Affiliation Agreement Request Form.

Academic Affiliation Agreement Request workflow

Once a request has been received via the CHHS - Affiliation Agreement Request Form, the following will happen:

• The Site Eligibility Coordinator (SEC) will check to make sure CHHS does not already have an agreement with the potential affiliate. If there is an existing agreement, the SEC will inform the individual and program.
• If there is not an existing agreement, the SEC will email a proposed affiliation agreement template to the affiliate contact with the requesting faculty copied.
  • If the affiliate accepts and signs the CHHS template, the SEC will then request the signature of the CHHS Dean.
  • Once that has been completed, the SEC will email the fully executed agreement to the affiliate contact, upload a copy to Exxat (with a copy to Legal Affairs) while tagging the appropriate programs, and inform all experiential learning coordinators within the appropriate programs of the addition of the new affiliate via email.

 If the affiliate would like to utilize their own agreement template OR would like to request changes to the CHHS template, the SEC will submit this information to the Office of Legal Affairs for their review. Note: this required action adds some additional time to the process as the SEC facilitates negotiations between the potential affiliate, Associate Dean of Clinical Affairs, and UToledo’s Office of Legal Affairs.

Once the potential affiliate and UToledo agree on the content of the agreement, the SEC will facilitate signatures from both parties.  The SEC will then email the fully executed agreement to the affiliate contact, upload a copy to Exxat (with a copy to Legal Affairs) while tagging the appropriate programs, and inform all experiential learning coordinators within the appropriate programs of the addition of the new affiliate via email.

Academic Affiliation Agreement Renewals

• At the beginning of each semester, the Site Eligibility Coordinator will generate a list of agreements set to expire of the following 90 days.
• This list will be shared via a survey to all clinical/fieldwork placement leaders in each program.
• Placement leaders will be asked to indicate which, if any, of the expiring agreements they would like to have renewed.
• Any agreement that even ONE program requests will be renewed.  Any agreements not indicated by any programs will be allowed to sunset.

Eligibility of Site Personnel (Supervisors, Preceptors, Clinical Instructors, etc.)

• In order to supervise a UToledo student at an experiential learning site, the direct supervisor/preceptor/CI must have the appropriate professional licensure, credential(s), and/or endorsement(s) on file with the College.
• All site personnel information will be securely stored within the College’s Exxat platform and will be managed by the Site Eligibility Coordinator.
• Site personnel should submit their contact information and supporting documentation here: 

Experiential Learning Credentialing Submission Form

Exemption and Declination Forms for Student Health Requirements

Exemption : The University of Toledo Health facilities allow limited exemptions for the MMR and seasonal influenza vaccines. Students may submit a request for an exemption through the University's vaccine registry. They would then upload documentation of the approval of the exemption(s) to their Exxat Approve dashboard.

Declinations:  Students may choose to decline the Hepatitis B and/or Tdap shots by completing the appropriate informed declination form acknowledging that they were made aware of the risks and are aware that they may choose to obtain these shots for free should they change their mind. Any completed forms should be uploaded to the student’s Exxat Approve dashboard.

Vaccine Declination form

Note: Requirements of individual sites outside of UToledo Health may vary as affiliates are granted the ability to set their own facility standards as noted in the academic affiliation agreement between the University and the site. Do not assume that a student’s exemptions at UToledo will be honored at an off-campus placement.