THIS AGREEMENT made in Duplicate as of the
day of
, 20
.
BETWEEN:
THE UNIVERSITY OF MANITOBA
Department Of Occupational Therapy
(hereinafter referred to as the "University")
-and-
(hereinafter referred to as the "Fieldwork Site")
WHEREAS it is in the mutual interests of the University and the Fieldwork Site that the
development of Occupational Therapy (O.T.) be furthered through the educational preparation of
occupational therapy students (hereinafter referred to as the “students”) of the University by way of
fieldwork experience at the Fieldwork Site (hereinafter, the “fieldwork placement”).
NOW THEREFORE this Agreement witnesseth that in consideration of the mutual covenants
herein contained the parties hereto agree that:
1.
Term. This Agreement shall commence on
.
2.
Liaison. Liaison between the University and the Fieldwork Site shall be by and through the
following persons:
(a)
on behalf of the Fieldwork site, the Fieldwork Site Director or designate.
(b)
on behalf of the University, the Academic Fieldwork Coordinator, Occupational
Therapy Department, College of Rehabilitation Sciences or designate.
(collectively referred to as the "Liaison").
The Liaison will meet in person or consult by telephone on a regular and planned basis.
3.
Responsibilities of Liaison. The Liaison shall plan in advance of the expected
commencement dates of each academic year, preferably two (2) or three (3) months in
advance, for the fieldwork education program of the University students at the Fieldwork
Site (the "Program").
The Liaison shall make any changes relating to the Program which are required during the
course of each academic term.
4.
Responsibilities of University. The University shall endeavour to present to the Fieldwork
Site as early as possible all necessary relevant information including:
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
the number of students being placed in the Program;
the respective education levels of the students;
the days and times of the student’s attendance;
the names and telephone numbers of academic staff members at the University who
will be involved with the Fieldwork Site;
the Occupational Therapy Department Fieldwork Policies;
a summary of the academic components of the curriculum;
the Occupational Therapy Department's expectations regarding the type of fieldwork
experience to be provided at the Fieldwork Site;
confirmation that the students have received training on the Personal Health
Information Act (PHIA);
completed Provincial Child Abuse Registry Check. The student will be responsible
for providing proof of a Provincial Child Abuse Registry Check prior to
commencement of the clinical placement; and
completed Criminal Record Check. The student will be responsible for providing
proof of a Criminal Record Check prior to commencement of the fieldwork
placement.
5.
Orientation Period. The Fieldwork Site and the University will plan and conduct a period
of orientation to the fieldwork placement experience for the students prior to the beginning
of the fieldwork placement. It is contemplated by the parties that the orientation period will
include the presentation of selected current policies as well as such regulations and
procedures as the parties deem appropriate.
6.
Facilities. The Fieldwork Site will provide to the best of its ability for the students of the
University, without charge to the University, such facilities at the Fieldwork Site as are
reasonable and appropriate including desks, telephones, lockers or change rooms, access to
a cafeteria and/or eating room, class and/or conference rooms, use of a library and a parking
space (to be provided free only if no parking charge is paid by other persons).
7.
Fieldwork Site Responsibilities. The Fieldwork Site shall be responsible for:
a)
b)
8.
instruction and supervision of student(s) during each fieldwork placement, and
such evaluation and reports as required by the University.
Workers Compensation. As students under the Workers Compensation Act (Manitoba),
students engaged in practicums who are resident in Manitoba are covered for physical
injuries in accordance with and subject to the provisions of the Workers Compensation
Act. In the event of an injury during the practicum the Field Site Supervisor should
promptly contact the University Liaison to ensure that coverage under the Workers
Compensation Act is secured.
9.
Indemnification. The University shall indemnify and save harmless the Fieldwork Site and
its officers, servants and agents from every action, suitor claim in respect of any injury, loss
or damage resulting from the grossly negligent acts or omissions by the University, its
officers or servants, when acting within the scope of their employment or by the students
when acting within the scope of the fieldwork placement, except to the extent that injury,
loss or damage is caused by the act or omission of the Fieldwork Site, or any of its officers,
servants or agents.
10.
Termination. This Agreement may be terminated any time by either party giving four (4)
months written notice to the other party, provided, however, any scheduled fieldwork
placement will not be terminated prior to completion (except where just cause exists in
relation to any individual student’s conduct during the corresponding fieldwork placement
as reasonably determined by the parties after mutual consultation).
11.
Amendments. The parties may amend any provision of this Agreement at any time upon
mutually so agreeing in writing.
12.
Risks. The Fieldwork Site shall, in keeping with its responsibilities to its’ clients and
patients, have the right to intervene in those instances where a student may be functioning in
a manner considered by the Fieldwork Site to be of potential risk to the well-being of the
clients or patients, or, contrary to the Fieldwork Site’s regulations, rules, policies or
procedures. In such event, and at the Fieldwork Site’s request , the University and
Fieldwork Site shall mutually consult and determine whether a student will be withdrawn
from a fieldwork placement if requested by the Fieldwork Site.
13.
Notice. All notices to be given by either party to the other under this Agreement shall be
delivered, or mailed by registered or certified post (postage prepaid) addressed to such other
party respectively as follows:
If to the Fieldwork Site:
If to the University:
With respect to amendment or termination of this Agreement:
The University of Manitoba
The Dean’s Office, College of Rehabilitation Sciences
R106 – 771 McDermot Avenue
Winnipeg, Manitoba R3E 0T6
With respect to day-to-day administration of this Agreement:
Academic Fieldwork Coordinator
Department of Occupational Therapy
College of Rehabilitation Sciences
R106 – 771 McDermot Avenue
Winnipeg, MB R3E 0T6
14.
Counterparts. This Agreement may be executed in any number of counterparts and by
different parties in separate counterparts, each of which when so executed shall be
deemed to be an original and all of which taken together shall constitute one and the same
agreement. Delivery by facsimile or by electronic transmission in portable document
format (PDF) of an executed counterpart of this Agreement is as effective as delivery of
an originally executed counterpart of this Agreement.
IN WITNESS WHEREOF the parties have hereto executed this Agreement on the day and year
first above written.
THE FIELDWORK SITE
THE UNIVERSITY OF MANITOBA
Per:
Per:
Administrator
(Print name beside signature)
Dean, College of Rehabilitation Sciences
S:\Legal\LEGAL OFFICE\Precedents\Website Documents\Signing Policy\Occupational Therapy Field Placement Agmt June 2015.doc