| Form Name: | Letter of Agreement (PLA) |
|---|---|
| Completed By: | Program Coordinator / Director |
| Used When: | Needed every time a rotation site is added, a site director changes, or when a previous one is expiring (usually every ten years) |
| Purpose: | An agreement between LSU School of Medicine programs and participating clinical sites. |
| Direct Questions To: | Frey, Rebecca and Thibodeaux, Savannah |
| Templates: | For All LCMC sites (UMCNO, Touro, Children's, EJGH, West Jeff, Tulane, Tulane Lakeside, Tulane Lakeview): For all Ochsner locations: 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. 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 entered into the online form. Instructions vary for each site. Refer to the PLA signatory page for instructions for each clinical site/signature. 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. |
Places This Form is Referenced
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I.B. Participating Sites (Accreditation)
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PLA (Terms and Abbreviations)
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Program Letter of Agreement (Terms and Abbreviations)
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Program Letter of Agreement (Forms & Documents)
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Letter of Agreement (Forms & Documents)