| Form Name: | Letter of Agreement (PLA) | |
|---|---|---|
| Completed By: | Program Coordinator / Director | |
| Used When: | Needed every time a program director changesrotation site is added, a site director changes, or when a rotation site is added, or previous one is expiring (usually every ten years years) | |
| Purpose: | An agreement between LSU School of Medicine programs and participating clinical sites. | |
| Direct Questions To: | Frey, Rebecca | Form Linkand Thibodeaux, Savannah |
| Templates: | For All LCMC sites (UMCNO, Touro, Children's, EJGH, West Jeff, Tulane, Tulane Lakeside, Tulane Lakeview), use the following: For All all Ochsner locations, use the following: For the VA: For Woman's Hospital (Baton Rouge): For all other clinical sites, use the following: | |
| PLA Signatories at Clinical Sites | View appropriate PLA signatories from each site | |
| Reminders | Include competency based goals and objectives when routing for signatures. This can be a separate Word or PDF document. As of April 18, 2022, digital signatures may be obtained through Adobe Sign. Digital is not the same as copied or scanned. If you do not have an Adobe Sign license, click here - Adobe Sign License Request (lsuhsc.edu) Adobe will send a fully executed copy to all email addresses enter entered into the online form. CC Sara Blakemore (sblak3@lsuhsc.edu) in the GME office to ensure that GME will receive their copy. Instructions vary for each site. Refer to the PLA signatory page for instructions for each clinical site/signature. Please follow the following process when routing for signatures: PLAs are not required by the ACGME for sites used for elective rotations. However, the specific site may require you to submit one. In addition to the site director, additional faculty can be listed as additional supervisors but are not required to sign the PLA. | |
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