Education - Project Xtern Facility Agreement

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Project Xtern Facility Agreement

Members, please note that this is not an online form to sign up to do an externship. This is solely for facilities that are agreeing to sign up to allow externs at their facilities. If you are already a member you do not need to apply. After registering in the Members Area of the website, click on Locate Xtern Site to find a participating facility.

Contact Information
Facility Name:
Facility Address:
Contact Name:
Contact Phone:
Contact Email:
Additional information (i.e. training from a particular school):

Referral Information
To whom may we thank for referring you to us:
Referral Name:
Referral Phone:
Referral Address:
How did you hear about us?	Local ChaptersWorkshopsWebsite Direct MailOther
	If other, please specify:
I agree to the Project Xtern terms and conditions.

News:

HIPAA Permits Student Access to PHI

Does minimum necessary allow students to access patient information during training?

Facility Tools:

Xtern Evaluation Form
This form can be used by our AAPC-AOES Project Xtern facilities to evaluate your AAPC Project Xtern Members performance.

General Use Sample Waiver
Release and Indemnification Agreement. A tool for participating AOES facilities.

Free Audio Conference for Facilities
Approved official Xtern facilities that sign up now will receive a certificate for one free audio conference.

Facility Logo for Marketing
If you are a facility that would like our Project Xtern Approved Official Extern Site logo for marketing, click the link above.

Downloadable Files:

	Project Xtern Overview
	Project Xtern FAQ