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Office of Academic Affiliations

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Affiliation Agreements

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

VHA Affiliations Partnership Councils

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).

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Medical Affiliation Agreements

Note: Effective October 1,2017, the VHA Office of Academic Affiliation (OAA) requires that all new and updated affiliation agreements routed to VA Central Office (VACO) should be sent via PDF and carry electronic signatures.

OAA Memo to Field: Conversion of Agreements to PDF

For assistance with affiliation agreements, please contact Yolanda Seward by phone at (804) 381-8374 or by email at Yolanda.Seward@va.gov


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 July, 2017


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 Affiliation 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 healthcare facility or agency.

VA Form 10-0094H (fillable)


Between the V.A. and another VA Healthcare Facility
For VA-sponsored programs where trainees receive training in another VA healthcare facility.

VA Form 10-0094I (fillable)


Psychology Internship Education Affiliation Agreements

Psychology Internship Education Affiliation Agreement Instructions

VA Form 10-00094j (fillable)
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DoD Agreements


Use of VA Facility to Maintain Clinical or Administrative Skills

VA-DoD Affiliation Agreement - VA Trainees going to Armed Service Medical Treatment Facility

VA-DoD Affiliation Agreement - Armed Service Trainee going to VA

VA-DoD Reserve Unit Sharing Agreement

VA-DoD Guard Unit Sharing Agreement

For all VA & DoD Healthcare Resources Sharing Agreements (including all maintenance of clinical skills and competencies under VA supervision) and for all DoD (Army, Air Force & Navy) Active Duty, Reserve, State Army National and Air Guard personnel who wish to train/practice in VHA facilities please contact Rochelle Clark at Rochelle.Clark@va.gov, or (202) 461-4143.