Va Form 10-0094f -Dental Education Affiliation Agreement Between Department Of Veterans Affairs (Va) And Institutions Sponsoring Dental Education
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5DENTAL EDUCATION AFFILIATION AGREEMENT
BETWEEN DEPARTMENT OF VETERANS AFFAIRS (VA)
AND INSTITUTIONS SPONSORING DENTAL EDUCATION
Use when dental trainees are enrolled in an academic program accredited by the Commission on
Dental Accreditation (CDA) and the accreditation is in the name of the sponsoring institution
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VA NETWORK
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VA MEDICAL CARE FACILITY (including city and state)
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AFFILIATED PARTICIPATING INSTITUTION #1 (including city and state)
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AFFILIATED PARTICIPATING INSTITUTION #2 (including city and state)
This agreement, when duly executed and approved by the Department of Veterans Affairs (VA), establishes
an affiliation between VA, its Veterans Integrated Service Networks, the listed VA facility or facilities, and the
listed institutions sponsoring dental education to affiliate for the academic purposes of enhanced patient care,
education, and research. VA and the affiliated institution have a shared responsibility for the academic enterprise.
VA retains full responsibility for the care of VA patients and administration of its operation. Additional
responsibilities are delineated below.
TERMS OF AGREEMENT
Ultimate responsibility for the control and operation of VA facilities and programs rests with VA. Ultimate
responsibility for academic education rests with the affiliated institutions. Through this agreement, a partnership
is created to enable enhanced patient care, education, and research.
The affiliated institutions comply with Title VI of the Civil Rights Act of 1964, section 504 of the
Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, Public Law 104-91, and the Age
Discrimination Act of 1975, and all related regulations, and assures that they do not, and will not, discriminate
against any person on the basis of race, color, sex, disability, or age under any program or activity receiving
federal financial assistance.
Nothing in this agreement is intended to be contrary to state or federal laws. In the event of conflict between
terms of this agreement and any applicable state or federal law, that state or federal law will supersede the terms
of this agreement. In the event of conflict between state and federal law, federal law will govern.
VA FORM 10-0094f
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