Clinical Affiliation Agreement Process

All forms have to be completed before you can begin your practicum.

Letter of Explanation to students/faculty from Dean, Debra Davis
Clinical Affiliation Agency Listings
Letter of Notification and Appreciation (1 page)
Letter of Notification and Appreciation (1 page fillable .pdf form - requires Adobe Acrobat 5.0 to complete online)
Two Page Agreement
Two Page Agreement - fillable .pdf form

Statement of Liability Insurance Coverage

Combination Pre-requisites and Verification of Health Insurance Forms

OR you can complete these two forms separately (see below)- but remember -BOTH forms have to be submitted with your paperwork.

Verification of Health Insurance
Verification of Health Insurance (fillable .pdf form - requires Adobe Acrobat 5.0 to complete online)
Pre-requisites For Clinical Practice Form
Pre-requisites For Clinical Practice Form (fillable .pdf form - requires Adobe Acrobat 5.0 to complete online)

For Additional Information

For additional information and transcript evaluation write to:

Office of Student Services
University of South Alabama College of Nursing
USA Springhill Campus
Mobile, Alabama 36688-0002
(251) 434-3410
Email: conbsn@usouthal.edu
FAX: (251) 434-3413

For information regarding admission to the University contact:

Office of Admissions
University of South Alabama
Mobile, Alabama 36688-0002
(251) 460-6141
1 (800) 872-5247
Email: admiss@usouthal.edu

The college is approved by the Alabama Board of Nursing
and accredited by the Commission on Collegiate Nursing Education
One Dupont Circle, NW, Suite 520
Washington, D.C. 20036-1120
Telephone 202-887-6791