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Affiliation Agreements

Handbooks | VHA Forms & Publications | VA Forms | VA Publications

Educational Affiliation Agreements

VHA Affiliations Partnership Councils
VHA Handbook 1400.3 Outlines procedural requirements for establishing, administering and maintaining Affiliation Partnership Councils and associated subcommittees or sub-councils (e.g., Medical Education Sub-council).

Between VA and and another VA Healthcare Facility (10-0094i) (fillable)
Use to establish an affiliation between a VA healthcare facility sponsoring an educational program and its Veterans Integrated Service Network, and another VA healthcare facility for the academic purpose of enhancing patient care, education, and research.

Between VA Central Office and an Educational Institution (10-0094m) (fillable)
Use when trainees enrolled in academic programs accredited by the appropriate nationally recognized accrediting organization obtain educational experiences at VA Central Office.

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Medical Education Agreements

Between the V.A. and a School of Medicine and its Affiliated Participating Institutions.
For programs accredited by the Liaison Committee for Medical Education (LCME) or the Accreditation Council for Graduate Medical Education (ACGME).

VA Form 10-0094A    (fillable) Revised September, 2014


Between the V.A. and a School of Osteopathic Medicine and its Affiliated Participating Institutions.
For programs accredited by the American Osteopathic Association Bureau of Professional Education or the Executive Committee of Council on Postdoctoral Training (ECCOPT).

VA Form 10-0094B (fillable)


Between the V.A. and Institutions Sponsoring Graduate Medical Education.
For ACGME-accredited programs not affiliated with a school of medicine.

VA Form 10-0094C (fillable)


Between the V.A. and a School of Medicine (Allopathic) and its Affiliated Participating Institutions.
Use when trainees are enrolled in an academic program accredited by the Liaison Committee for Medical Education (LCME).

VA Form 10-0094K (fillable)


Between the V.A. and Institutions Sponsoring Osteopathic Graduate Medical Education and their Affiliated Osteopathic School of Medicine.
Use when trainees are enrolled in an academic program accredited by the Commission on Osteopathic College Accreditation or the American Osteopathic Association Program and Trainee Review Council (PTRC).

VA Form 10-0094L (fillable)


Between the V.A. and Institutions Sponsoring Osteopathic Graduate Medical Education.
Use when trainees are enrolled in an academic program approved by the American Osteopathic Association Program and Trainee Review Council (PTRC) NOT affiliated with a school of osteopathic medicine.

VA Form 10-0094N (fillable)

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Dental Education Agreements

Between the V.A. and a School of Dentistry as the Sponsoring Institution.
For programs accredited by the Commission on Dental Accreditation ( CDA ) and the accreditation is in the name of the dental school.

VA Form 10-0094D (fillable)


Between the V.A. as the Sponsoring Institution, and a School of Dentistry and its Affiliated Institutions.
For programs accredited by the Commission on Dental Accreditation ( CDA ) and the accreditation is in the name of VA.

VA Form 10-0094E (fillable)


Between the V.A. and Institutions Sponsoring Dental Education
For programs accredited by the Commission on Dental Accreditation ( CDA ) and the accreditation is in the name of the sponsoring institution.

VA Form 10-0094F (fillable)

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Associated Health Education Agreements

Between the V.A. and an Educational Program.
For programs approved by an accrediting body recognized by the U.S. Department of Education or by the Council for Higher Education Accreditation (CHEA).

VA Form 10-0094G (fillable)


Between the V.A. and a non-VA Healthcare Facility or Agency.
For VA-sponsored programs where trainees receive training in a non-VA health care facility or agency.

VA Form 10-0094H (fillable)


Psychology Internship Education Affiliation Agreements

Psychology Internship Education Affiliation Agreement Instructions

VA Form 10-00094j (fillable)
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