Individual Clinical Experience Agreement

At this time, Allina Health is not completing any new agreement requests for non-employees. If your program is not listed in our Academic Affiliations, we are unable to support your experience. If you have been granted an exception-based approval or are an Allina Health employee whose Academic Affiliation is not associated with Allina Health, please complete the following:

**You must have an approving preceptor before starting this process.

• Student Name:

• Student Discipline:

• Clinical start date

• Expected clinical end date:

• Accepted preceptor(s):

• Allina Health site:

• Academic Affiliation:

• Academic Affiliation Agreements Contact Email:

We will confirm placement and approval. Once confirmed, we will initiate the agreements process with your Academic Affiliation. Once the agreement is complete, onboarding resources will be sent to both the school and student.

• An accepting preceptor or experience does not guarantee an approved clinical placement, an established Individual Clinical Experience Agreement is Required
  
  

• If this is a project based experience, an established CEA does not guarantee an approved clinical placement. Please complete the project request form. Once you receive approval, please initiate the Individual Agreement Request.