Va Form 10-0094d - Dental Education Affiliation Agreement Between Department Of Veterans Affairs (Va) And A School Of Dentistry As The Sponsoring Institution
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6DENTAL EDUCATION AFFILIATION AGREEMENT
BETWEEN DEPARTMENT OF VETERANS AFFAIRS (VA)
AND A SCHOOL OF DENTISTRY AS THE SPONSORING INSTITUTION
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 dental school
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VA NETWORK
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VA MEDICAL CARE FACILITY (including city and state)
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SCHOOL OF DENTISTRY (including city and state)
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AFFILIATED INSTITUTION # 1 (including city and state)
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AFFILIATED 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 facilities, the school of
dentistry and its affiliated participating institutions for the academic purposes of enhanced patient care, education,
and research. Dental schools and their affiliated institutions that are signatories to this document are collectively
referred to as “partner institutions.” All parties to the agreement have a shared responsibility for the academic
enterprise. The partner institutions accept primary responsibility for the integrated education programs conducted
with VA while VA retains full responsibility for the care of VA patients and administration of its operation.
Additional responsibilities are delineated below.
BACKGROUND
The provision of education for future health care providers and the conduct of research are VA statutory
missions. By virtue of the close relationships between VA and the nation’s academic institutions, VA plays a
leadership role in reshaping the education of future health care professionals to help meet the complex scope of
the nation’s health care delivery system. It is the intent of VA to maintain its long-standing practice of effective
affiliations with educational institutions for the purposes of contributing to continued excellence in VA patient
care and conducting joint academic programs that address health manpower needs throughout VA and the nation.
An affiliation agreement promotes common standards for patient care, resident and student education,
VA FORM 10-0094d
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