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 submit and commit to an appropriate affiliation agreement.

Please complete this affiliation request to provide information about your institution and help us identify the appropriate affiliation agreement for your needs. (3-Way affiliation agreement or an agreement for a high school, public or private academic institution). When you receive Covenant Health’s affiliation agreement form, please fill out the gray-colored fields and have your information reviewed by the appropriate officials at your academic institution.

In order for an affiliation agreement to be valid, at least one original agreement must be signed by the institution’s representative, as well as by Covenant Health’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

When you have received and completed your institution’s affiliation agreement form/documents, please return as noted below:

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: [email protected]

For all other agreements (high school, public and private academic institutions), the final form/documents and any questions about the agreement can be forwarded to Covenant  Health’s 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: [email protected]