UTRGV's Clinical Request Form: adding a new clinical site

Q: Where is the current UTRGV Clinical Request Form?

Inside Brightspace. The Spring 2026 NURS 6613 forms list links it through DocuSign; PMHNP students should ask their clinical faculty or the program for the current copy. The public PDFs were removed from UTRGV's website, and archived ones show the fields but may be out of date, so use the version your course links to.

Q: Do DNP students use the Clinical Request Form?

The 12-24 form has a DNP box, and NURS 8512 asks DNP students to submit affiliation agreement forms by week two if they were not filed earlier. UTRGV does not say who finds the DNP project site, so raise it with your DNP project faculty advisors early in the project courses.

Updated September 27, 2026 · Reviewed by the UTRGV Preceptor placement team

When your preceptor works at a facility UTRGV has no agreement with, the Clinical Request Form starts one. UTRGV uses a single form for every program from the BSN to the DNP, and its PMHNP guidelines put the wait for the agreement at 30 to 90 days when the request is complete. Here is what the form asks for, the two kinds of agreement, who handles each step and how to keep the clock short.

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30-90days for an affiliation agreement when the request is accurate and complete (UTRGV PMHNP guidelines)

6program checkboxes on the 12-24 Clinical Request Form, BSN through DNP

Numbered steps. The 30 to 90 day lead time: 1 Your first clinical day; 2 At least 7 days before; 3 Up to about 97 days before; 4 Earlier still. — The 30 to 90 day lead time: 1 Your first clinical day; 2 At least 7 days before; 3 Up to about 97 days before; 4 Earlier still.

What the form is for

An affiliation agreement is the contract that lets UTRGV students train at a facility. Sites that already have one sit on the approved list in Brightspace (how that list works); for anywhere else, the Clinical Request Form asks UTRGV to set one up. The Spring 2026 NURS 6613 syllabus files it among the forms for new affiliations and preceptors, sent through DocuSign.

The form opens a contract with the facility. It does not approve your preceptor for a course by itself: your course coordinator or clinical faculty still signs off on the preceptor and site, and hours begin only after both the agreement and that approval are in place.

One form, BSN to DNP: the fields

The latest public version, labeled 12-24, uses one row of checkboxes for the BSN, MSN administration, MSN education, FNP, PMHNP and DNP. The two MSN boxes outlived their programs, which left the catalog after 2023-24, and the public copy of the form has since been taken down.

What the 12-24 form asks for

Your program, ticked from the six boxes.
The facility name, written the way the organization signs contracts.
The individual responsible for approving agreements for that facility.
The preceptor's name.
Initiating faculty. UTRGV does not explain this field publicly, so ask your course faculty whom to list.

The form ends with a line on sequence: once the agreement is authorized, you present the course objectives and clinical practice can begin.

Standard or non-standard agreement

UTRGV's PMHNP guidelines describe two routes to an agreement. Which one a site takes is the facility's call, so ask early which it prefers and who signs its contracts.

The two agreement routes in UTRGV's PMHNP Clinical Request Form guidelines
Route	Whose document	Who approves it	What to ask the site
Standard	UTRGV's own affiliation agreement	The clinical site processes and approves it	Can you sign the university's template?
Non-Standard	The clinical site's own agreement	The UTRGV authorizing official	Who will send your contract, and when?

The non-standard route adds a review on UTRGV's side, so a facility that insists on its own paperwork needs the earliest possible start.

The 30 to 90 day lead time

The timing comes from one sentence in UTRGV's PMHNP guidelines: "Affiliation agreements take from 30 to 90 days for processing and approval if information is accurate and complete." The FNP syllabi give no separate figure, and UTRGV publishes no program-wide deadline for new sites.

The condition at the end of that sentence matters as much as the numbers. A misspelled facility name, a missing contract signer or a preceptor who has not actually agreed can only slow the request down.

Counting back from your first clinical day, our planning (not a UTRGV rule) looks like this:

Your first clinical dayHours start only once the agreement is authorized and faculty have cleared the site.
At least 7 days beforeFNP courses expect the signed preceptor agreement and weekly time report to be filed.
Up to about 97 days beforeA new agreement can need 90 days, plus that week of filing time. This figure is our arithmetic.
Earlier stillTime to find the preceptor, confirm the facility's details and complete the form.

Who does what on a new affiliation

You pick the site and preceptorConfirm the preceptor is willing and qualified for your course and get the name of whoever approves contracts. PMHNP students also show the site their program acceptance letter.
You complete and return the formFNP students send it through DocuSign from the course forms area. The PMHNP guidelines send the finished form back to the graduate nursing office and to PMHNP faculty.
UTRGV contacts the facilityFor the PMHNP, the PMHNP unit reaches out to the contact person you listed. UTRGV does not describe the FNP routing in the same detail.
The facility signs or sends its ownThe site approves the standard agreement or submits its own for the UTRGV authorizing official.
UTRGV confirms completionGraduate program staff notify you when negotiations are finished.
You finish the preceptor paperworkTyphon data sheet, preceptor agreement and course objectives, then faculty clearance before your first hour. Who does what sorts out each role by title.

Typhon data sheets for new preceptors

A new site usually means a new preceptor profile too. The NURS 6613 forms list pairs the request form with three Typhon data sheets, one each for an NP, a PA and a physician, matching the three kinds of preceptor the FNP clinical courses accept. PMHNP students upload a preceptor data sheet to Typhon in week one of NURS 6476, after every party has signed, and DNP students hand in one for a physician or DNP-prepared APRN in NURS 8512.

UTRGV does not publish the sheets' fields. Ask your course faculty for the current version the day a new preceptor agrees, so the sheet is ready by the time the agreement is. Typhon and preceptor requirements cover the rest.

Archived copies and what their labels mean

The public PDFs are gone from UTRGV's website, so older copies circulate. This is what each one is:

UTRGV Clinical Request Form versions
Document	Label or date	Status	What it adds
Student Clinical Request Form	Version 12-24; created December 2024, revised March 2025	Removed; archived May 2025	One form for BSN through DNP; facility, signer, preceptor and initiating faculty fields
PMHNP guidelines for the Clinical Request Form	Revised December 2023	Removed; archived October 2024 and May 2025	Acceptance letter, the two agreement routes, 30 to 90 days
Student Clinical Request Form, 2021	2021	Removed; the archived file is damaged	Unreadable
Clinical Request Form via DocuSign	Current	In Brightspace, on the `NURS 6613` forms list	The version to use now

Use whatever your course links to today. The archived copies explain the process, but the live form may have changed.

How we prepare a new site

When the approved list has nothing that fits, your placement advisor finds a preceptor who has agreed in principle, then collects everything the request needs before it goes in: the facility's legal name, the person who approves its contracts, whether it uses its own agreement, and the preceptor's details for the Typhon data sheet. A complete request gives you the best chance at the short end of the range.

We stay in touch with the site while the agreement moves and keep a listed-site option in view in case the contract stalls. The request form starts the search.

Questions UTRGV students ask

Can I start clinical hours while the affiliation agreement is pending?

No. The Clinical Request Form says clinical practice begins once the agreement is authorized and the course objectives are presented, and your course coordinator or clinical faculty must still clear the site. If your course starts soon, a site already on the approved list is the faster route.

Where is the current UTRGV Clinical Request Form?

Inside Brightspace. The Spring 2026 NURS 6613 forms list links it through DocuSign; PMHNP students should ask their clinical faculty or the program for the current copy. The public PDFs were removed from UTRGV's website, and archived ones show the fields but may be out of date, so use the version your course links to.

Do DNP students use the Clinical Request Form?

The 12-24 form has a DNP box, and NURS 8512 asks DNP students to submit affiliation agreement forms by week two if they were not filed earlier. UTRGV does not say who finds the DNP project site, so raise it with your DNP project faculty advisors early in the project courses.

What if the clinic wants to use its own contract?

That is the non-standard route: the facility sends its own agreement and the UTRGV authorizing official reviews and approves it. It adds a step compared with signing UTRGV's template, so tell your course faculty as soon as you know, and allow the full 30 to 90 days.

Who signs the affiliation agreement for the clinic?

Whoever approves contracts for that facility, which may or may not be your preceptor. The form asks for that person by role. In a small practice it is often the owner; in a larger group it may be a manager or a legal office. Getting the right name the first time keeps the request moving.

UTRGV systemApproved preceptor listUTRGV posts approved preceptors and affiliated Evergreen sites in Brightspace. What the list is, why a listed site can still decline, and when to look past it.UTRGV systemPlacement processEvery published step of UTRGV clinical placement for FNP and PMHNP students, from buying Typhon and picking a site to the preceptor agreement and final forms.UTRGV systemWho does whatThe UTRGV roles behind your clinicals, by title: course coordinator, clinical faculty, lab instructor, program coordinators, graduate staff and DNP advisors.TyphonTyphonHow UTRGV nurse practitioner students use Typhon: one purchase for the MSN, logging hours and encounters, preceptor data sheets, signed logs and who sees them.UTRGV systemPMHNP placement assistanceUTRGV's PMHNP flyer offers preceptor placement assistance; its archived FAQ said students secure their own site. What each says, what to ask, and how we help.Placement helpNo preceptor yetA UTRGV NP student with NURS 6612, NURS 6613 or a PMHNP practicum close and no preceptor: this week's steps, from your course coordinator to new sites and us.

Last checked 2026-09-27

We check these pages against UTRGV's own catalog, course syllabi, School of Nursing pages and Texas Board of Nursing rules. Your course faculty and the School of Nursing have the final word.

From the approved list or a brand-new site, we find the preceptor who fits.

Tell us your UTRGV program, where you live and when your next clinical course starts. We line up a willing preceptor who fits the course and UTRGV's rules, and hand you the details the Clinical Request Form, the affiliation agreement and the preceptor agreement ask for, well before the semester.

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