Program Letter of Agreement Generator

The following questions are asked and then the form is completed automatically

NOTE: Please complete the following information which will populate the form.
  • After the form is complete, please print it, get the Program Director and away site preceptor's signatures and forward to GME.
  • A complete PLA (including signatures of program director and away site director) must be received by GME in advance of the rotation start date:
    • 30 days for in-state rotations
    • 60 days for out-of-state rotations
    • 90 days for out-of-country rotations
Affiliation Site Information
Yes -- OCA number
Rotation (Non-elective) activity Rotation (non-elective) activity that most if not all trainees participate in. Please indicate the average length of time for the rotation, and the name of activity that will be used to schedule on in MedHub.
Full time (40+ hours per week)
Part time (less than 20 hours per week)
Research activity - IRB If this is a research related activity, do you have IRB approval? (If yes, please send a copy of IRB approval letter to GME.)
For assistance, please contact the Graduate Medical Education Office at 503 494-8652.