Live Online Clinical & Research Experience Details Form

This information will be used to introduce you and the details of your Clinical Site to medical students, schools, foreign governments and other sponsors for enrollment, so please be as accurate as possible. If a particular information is subject to change, then please say so. The more accurate the information you provide, the better everyone’s experience will be. For current AmeriClerkships Affiliates, this Exhibit C-2 will be digitally attached to your most recent Clinical Mentorship Affiliation Agreement as an addendum.