Interviewing and Affiliation Agreements - Student Information (only)
See CSD Graduate Student Handbook for complete details pertaining to Externship and Affiliation
Agreements.
Call/visit the site
 First: Call the main number and ask for the Speech-Language Pathology department.
 Second: Ask for the individual that coordinates rotations for Speech-Language Pathology
externship students at the site. Do not ask for a specific supervisor. Be prepared to provide the
site with the following items in the box below.
 Remember---If the site said that only the course instructor may contact the site, do not contact the
site. Contact your course instructor.
YOU MUST BE PREPARED TO PROVIDE YOUR COURSE INSTRUCTOR AND THE POTENTIAL SITE THE
FOLLOWING ITEMS!
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Resume
NAU unofficial transcript
Start and end dates of your rotation
Letter of recommendation – only one
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608 Guidelines (on website) –have ready to discuss with the site
CSD Registration Checklist – Show this or email this to the site (see details below)
Ask them if they require a specific company to be used for your registration at their site – some sites
use OCO, MyClinicalExchange, or another company; if they require a specific company to complete
registration, get details! You will be asked for this information on the Externship Registration form
that the CSD department uses
When interviewing, make sure you discuss the CSD Registration Checklist!
Tell them something like this:
 I have a Registration Checklist that I have to submit when registering for the course. Some items are
waiver eligible. Are there any items on this list that your site does not require? If so, please provide
me with an email stating this information. I need to submit that email with other information when I
start registering for the course.
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Are there items that are not on the CSD Registration Checklist that you require? What are they?
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Do you use a specific organization (like OCO, MyClinical Exchange, and others) that you want me to
register with?
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Are there specific items that my course instructor needs to follow?
Revised: February 5, 2016
Interviewing and Affiliation Agreements - Student Information (only)
Part-time Summers-Only students are required to provide the course instructor with their resume, their
unofficial transcript, and one letter of recommendation before they start seeking an Externship site. Email
these three items to your course instructor. Information will be kept in a private student folder. If you want
any information changed, email a revised document to your course instructor.
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Make sure that you tell them the correct information about how much time you are required to be
at the site.
o 12 weeks. Monday – Friday. 8 AM – 5 PM. (This totals 540 on-site hours.) (Flexibility is allowed,
if approved by the course instructor.)
o Sites may vary in their requirements.
o Finalize your start and end dates, with your supervisor, at the time of your interview.
o Let them know that you only log your direct contact hours. (You do not log or keep track of the
540 on-site hours.) Direct clinical contact hours include evaluation, treatment, and feedback
time. It does not include observation or preparation time.
o Your supervisor will be using CALIPSO at mid-session and end-of-session for your grade, unless
you starting logging hours using the “old way”. A minimum of 25% supervision is required.
How this is achieved is determined between you and your supervisor.
o By the end of the Externship, make sure that you have the required number of hours for each of
the following and share this information with your supervisor.
ASHA/NAU – 375 direct clinical contacts hours plus 25 observation hours.
Your specific state – always important to look at your own state’s requirements
o Part-time students: Before the course starts, you are required to provide the supervisor with
the CSD 608 syllabus and a Letter of Introduction that your course instructor has emailed to you.
A couple of weeks after the course starts, the course instructor will make contact with your
supervisor. The course instructor will email the same items listed above to the supervisors. Be
certain that you have already given these items to your supervisor.
o Part-time students: Refer to the document “Externship sites-additional information” attached
to each newsletter. This provides information pertaining to sites that have specific directives
that differ slightly from our usual procedures. This is not a comprehensive list of all possible
sites!
Affiliation Agreements
 We use a College of Health and Human Services database to obtain information pertaining to
possible sites. If the site that you want is not on this database, you may inform your course
instructor of your need for an agreement to be established.
 First, you contact the site and determine if they are interested in having you as an Extern.
Some sites only want to be contacted by the course instructor. They do not want to be
contacted by a student. You or I will provided detailed information to the site (information
in the box on the first page).
Revised: February 5, 2016
Interviewing and Affiliation Agreements - Student Information (only)
 Second, if they are interested in having you as an Extern, but we do not have an agreement
with the site, you are responsible for sending the site the following document which is
located on the CSD website:
“Affiliation Agreements – Information needed from the Site”
 Third, the site emails the above document to your course instructor. The form will indicate
whether they will use our affiliation agreement or if they require submitting their affiliation
agreement.
 Your course instructor will submit all necessary documents to the legal department.
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Your course instructor will, also, indicate whether they have agreed to use our agreement (which is
called Standard) or whether they will only use their agreement (which is called Non-Standard).
Email Cindy.Doyen@nau.edu (Part-Time students) or KimFarinella@nau.edu (Full-Time students) if
you would like to obtain information about possible sites from the database. You can only request
the information by state. You will be emailed the state information that you request.
Show preference to sites that say that the Affiliation Agreement:
o Is with the College of Health & Human Services (CHHS) or Communication Sciences and
Disorders (CSD).
o Is “Fully Executed” (current and acknowledged by NAU and the site).
o Has an acceptable expiration date.
o Be somewhat cautious of sites that say that the Affiliation Agreement is “Active”.
o Beware of sites that say that the Affiliation Agreement is “Pending”.
o But, don’t forget that you may choose a site that is not on the list, too!
The NAU Affiliation Agreements department requests that all correspondence related to
establishing an Affiliation Agreements be done electronically, via email (no hard copies). Always use
the forms located on the CSD website. Do not save forms to your computer’s desktop, as they may
have old information.
It is important to remember that multiple individuals have to handle each Affiliation Agreement and
multiple departments in the College of Health and Human Services require Affiliation Agreements,
not just CSD. Affiliation Agreements will be processed on a first come/first served basis.
The Arizona Board of Regents will not allow any AZ school to sign an Affiliation Agreement with an
“Indemnification Clause” unless it allows altering of the language used. Altering language between
the legal offices can take between 6 -12 months. Almost all hospitals have an Indemnification
Clause that can be altered by working with our legal department. Do not be discouraged. We are
usually successful in altering language with the site.
It is possible for you to have more than one supervisor at a site. Include all supervisor information
on the “Externship Information form”. It is possible for you to have two different sites.
Securing a rotation at a hospital has become extremely competitive. Many hospitals interview
students one year prior to the rotation.
It is the responsibility of the student to find out about any “extra requirements” required by a site
that are not on the CSD Registration Checklist.
Revised: February 5, 2016
Interviewing and Affiliation Agreements - Student Information (only)
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It is the responsibility of the student to complete the “extra requirements” on time.
(Part-Time students) Refer to the document “Affiliation Agreements – additional information”
provided to you by your course instructor. Some sites have specific directives regarding this
process.
Three possible scenarios will occur after being accepted by the site
1. If we already have a completed and current Affiliation Agreement with the site, all you need to do is
complete the “Externship Information” form and the “Registration Checklist for Clinical Experience”. Email the two forms to speech@nau.edu. Register for the course.
2. If we do not have an Affiliation Agreement with the site, email the site the form “Affiliation
Agreements: Information Needed from the Site”. Only they are allowed to complete this form. Please
make sure that you inform them that this is simply the first step in the process and IS NOT THE ACTUAL
AFFILIATION AGREEMENT! The site needs to return it to your course instructor. If, on the form, the site
indicates that THEY WILL use an NAU Affiliation Agreement, they email that one form to
Cindy.Doyen@nau.edu (Part-Time students) or Kim.Farinella@nau.edu (Full-Time students). CSD will
start the Affiliation Agreement process. Once finalized, you will be notified. Please avoid contacting the
CSD department during the legal process, as we do not have any information to provide you. The course
instructor will notify you when they have information to share. Never contact the site, as they do not
like to be contacted during the process. When your course instructor notifies you that the Affiliation
Agreement is approved, complete the “Externship Information” form and the “Registration Checklist for
Clinical Experience” form. Email the two forms to speech@nau.edu. Register for the course.
3. If we do not have an Affiliation Agreement with the site, email the site the form “Affiliation
Agreements: Information Needed from the Site”. Only they are allowed to complete this form. Please
make sure that you inform them that this is simply the first step in the process and IS NOT THE ACTUAL
AFFILIATION AGREEMENT! The site needs to return it to your course instructor. If, on the form, the site
indicates that THEY WILL NOT sign an NAU Affiliation Agreement, and want to use their Affiliation
Agreement, they will need to send their Affiliation Agreement, electronically. They will email the two
documents, “Affiliation Agreements-Information Needed from Site” and their Affiliation Agreement to
Cindy.Doyen@nau.edu (Part-Time students) or Kim.Farinell@nau.edu (Full-Time students).
CSD will start the Affiliation Agreement process. Once finalized, you will be notified. Please avoid
contacting the CSD department during the legal process, as we do not have any information to provide
you. The course instructor will notify you when they have information to share. Never contact the site,
as they do not like to be contacted during the process. When your course instructor notifies you that
the Affiliation Agreement is approved, complete the “Externship Information” form and the
“Registration Checklist for Clinical Experience” form. Email the two forms to speech@nau.edu. Register
for the course.
Revised: February 5, 2016
Interviewing and Affiliation Agreements - Student Information (only)
Final information
 After the CSD office receives your “Externship Information” form and the “Clinical Experience
Registration Checklist” form, they will make it possible for you to register for the course on-line
(assuming that NAU has started the registration for that particular semester/session). All
information must be completed on the forms. You are not to start at the site until your
registration in the course appears on your transcript, you are on the course instructor’s roster,
and you do not start earlier than NAU start dates.
 Your syllabus will be on Blackboard Learn before the start of the session. All required forms
are on the CSD website.
Revised: February 5, 2016