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Affiliation Agreement for Academic Institutions

Educational Partnerships for On-site Learning at Covenant Health

Thank you for your interest in establishing an educational partnership with Covenant Health. We are proud of our history in partnering with hundreds of academic institutions to offer education for future healthcare professionals at our member organizations. To formally establish a relationship for student learning on-site at any of our Covenant Health organizations, each academic institution must commit to the appropriate affiliation agreement.

Please complete the form below to receive the appropriate agreement for your institution. The agreement will be in a form document.

When you receive the affiliation agreement form, please fill out the gray-colored fields and have the form reviewed by the appropriate officials at your academic institution. In order for the affiliation agreement to be valid, at least one original agreement must be signed by the institution’s representative, as well as by Covenant’s Vice President of Learning and Leadership Development. Our Senior Vice President and Chief Medical Officer must sign all 3-Way Affiliation Agreements, which also must include the supervising physician’s signature.

 Each agreement is in effect for a duration of five (5) years.

Contact Information 

For all 3-Way Affiliation Agreements, contact:

Mary Long, CPMSM
Covenant Health
280 Fort Sanders West Blvd., Bldg. 4, Suite 205
Knoxville, TN 37922
Phone: (865) 531-5336
Fax: (865) 531-5381
Email: mlong@covhlth.com

For all other agreements (high school, public and private academic institutions), final documents and any questions about the agreement can be forwarded to the Learning & Leadership Development team:

Learning & Leadership Development
Covenant Health
1400 Centerpoint Blvd.
Building A, Suite 101
Knoxville, TN 37932
Phone: (865) 374-8117
Fax: (865) 374-8124
Email: lld@covhlth.com

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