The ACGME requires all programs to execute Program Letters of Agreement (PLAs) with Participating Institutions (Affiliating Entities) where their residents rotate. PLAs are not part of, nor take away from, the required Contracts, Affiliation Agreements, and Supplements that are administered through the LSUHSC Contracts Office. Three (3) original PLAs must be generated, and each requires An original PLA must be executed through Adobe Sign requiring signatures of the Program Director and , the site director Site Director who oversees the residents at the affiliating entity and , the Designated Institutional Official and the signature of the affiliating entity (CEO, Medical Director, etc). Once completed, the first original stays with a fully executed PLA is automatically forwarded to the training program, the second is submitted to the Director of Accreditation, and the third remains at the participating institution. In addition, the signature of an affiliating entity (CEO, or Medical Director) may be required. The The Letter of Agreement is valid for ten years unless there is a change of a Program Director or site director Site Director, which requires the execution of a new letter. It is the responsibility of the individual programs to execute the PLAs. A template can be obtained on the Office of Graduate Medical Education Knowledge Base https://lsugme.atlassian.net/wiki/spaces/FORMDOCS/pages/11698563/Letter+of+Agreement.