FORMS AND AFFILIATION AGREEMENTS

Download Affiliation Agreement

Before starting a rotation, NYDDI must have a written affiliation agreement with the facility.

To execute an agreement, facilities need to meet the following criteria:

  • Have a qualified individual present to supervise the intern. Only a Registered Dietitian /Registered Dietitian Nutritionist (RD/RDN) is acceptable to supervise the clinical rotation.

  • An RD/RDN or an appropriate degreed professional for the community rotation. A clinic site must schedule a minimum of twenty-five (25) clients per week.

  • An RD/RDN or certified food service professional for the food service rotation. For a foodservice rotation, the site must serve a minimum of 60 meals per day.

  • An RD/RDN or an appropriate degreed professional for the health and nutrition influencer rotation.

Our program review facilities and preceptors for suitability upon submission in the DI app.

Affiliation agreements are legal documents that must be in place before an intern can start working at a facility. The Affiliation Agreement outlines in writing the relationship between the three parties (Facility, New York Distance Dietetic Internship, and the Intern).

Once an intern has made arrangements with their preceptor, the next step is to follow up with an Affiliation Agreement. Interns provide their preceptors with the NYDDI Affiliation Agreement on our website listed under forms.

Interns need to identify the proper title, name, email address, contact phone, date, and related information. Accuracy in spelling is critical.

Once completed and signed, please ask the preceptor to return the form TO THE INTERN. After checking for a signature and date, the intern uploads the form in the DI app.

There are a few nuances regarding Affiliation Agreements interns need to be aware of before starting rotations.

Once the rotation begins, should an intern choose a new or different preceptor and facility, the intern will need to complete a new preceptor and  facility form and Affiliation Agreement.

  1. If an intern makes arrangements with a Consultant Dietitian, the intern needs the Preceptor and Facility form and Affiliation Agreement, for each location the Consultant works.

  2. If an intern is working at a facility less than one week e.g., filling in missing days, an Affiliation Agreement can be waived. Instead, an email is sent from the preceptor outlying the arrangement.

  3. If the intern works five or more days at any facility, a separate Preceptor and Facility form along with an Affiliation Agreement is required.

Note: Frequently facilities prefer to use their own Affiliation Agreements. That is fine, however it needs to be emailed to our office at nyddi@yahoo.com for our review and signature. If NYDDI has concerns with the facility agreement we will email or call the preceptor, who in turn can communicate these concerns with their administration.

Once approved we sign the agreement, we send it back to the preceptor and intern. The last step is the intern uploads the signed form into the DI app.

If in doubt check with NYDDI.

One last comment about facilities and preceptors. An intern may not begin a rotation until the required documentation is in place:

  • Preceptor and Facility Form

  • Affiliation Agreement

Both can be found under the Forms heading in our website www.nyddi.com