Please provide information related to institutions that are without affiliation agreements or for which existing affiliation agreements do not comply with one or more stipulations identified below. Provide additional information in the comments section. Missing Has not No delineation No delineation of CAO/DIO Missing Is not Affiliation been No Formal of Financial educational effective or forwarded expired/not No site reaffirmed Institution/Private Practice Name agreement support contribution date signed to the PD renewed coordinator every 5 yrs. Comments:
Please provide information related to institutions that are without affiliation agreements or for which existing affiliation agreements do not comply with one or more stipulations identified below. Provide additional information in the comments section. Institution/Private Practice Name No Formal agreement No delineation of Financial support No delineation of educational contribution Missing CAO/DIO Missing effective or date signed Is not forwarded to the PD Affiliation expired/not renewed No site coordinator Has not been reaffirmed every 5 yrs. Comments:
CPME%20370%20Team%20report%20for%20PMSR%20-%20Revised%20September%202016.docx