AFFILIATION AGREEMENTS:   Please print off TWO copies of affiliation agreement.  Make sure that all information is complete (ie: facility name, city, state, zip code, phone and fax numbers, as well as your name and facility administrator name for signature page).  Please submit two copies to your site for signatures.  Once signature has been obtained, please send both signed agreements back to me to obtain signature here from WSU.   Affiliation agreements MUST be signed by clinical facility and WSU officials, and placed in your file before course work begins in August.  A separate agreement needs to be completed for every clinical site.   *** If your site prefers to utilize their own agreement, please make sure that we have a copy of their agreement for our legal department to review.  If this is the case, the process may take several months to complete.

    RPA/RA Affiliation Agreement Form (click here)

    RADIATION THERAPY Affiliation Agreement Form  (click here)

    CARDIAC/MEDICAL DMS Affiliation Agreement Form (click here)

Please mail signed copies to:    Weber State University
                                            Department of Radiologic Sciences
                                            ATTN:  Nancy Palmer
                                            3925 University Circle
                                            Ogden, UT  84408-3925

If you have questions, please feel free to contact me.  801-626-8167

 

 
Send me an e-mail
npalmer@weber.edu