{"id":1892,"date":"2017-06-12T08:30:29","date_gmt":"2017-06-12T14:30:29","guid":{"rendered":"https:\/\/sites.austincc.edu\/health\/?page_id=1892"},"modified":"2026-02-06T15:27:10","modified_gmt":"2026-02-06T21:27:10","slug":"affiliation-agreement-request-form","status":"publish","type":"page","link":"https:\/\/sites.austincc.edu\/health\/facstaff\/affiliation-agreement-request-form\/","title":{"rendered":"Affiliation Agreement Request Form"},"content":{"rendered":"

[vc_row][vc_column width=”1\/6″][\/vc_column][vc_column width=”2\/3″ css=”.vc_custom_1770410287832{background-color: #ffffff !important;}”][vc_column_text css=”.vc_custom_1770410319131{padding-bottom: 20px !important;}”]<\/p>\n

Inside of Service Area<\/h3>\n

Affiliation Agreement Request Form<\/h1>\n

[\/vc_column_text][vc_empty_space height=”1.5rem”][vc_btn title=”Return to Service Area” style=”custom” custom_background=”#003366″ custom_text=”#ffffff” size=”sm” link=”url:https%3A%2F%2Fsites.austincc.edu%2Fhealth%2Ffacstaff%2Faffiliation-agreement-request-service-area%2F|title:Affiliation%20Agreement%20Request%20Service%20Area||”][vc_empty_space height=”1.5rem”]\n

\n

<\/p>

    <\/ul><\/div>\n
    \n
    \n<\/fieldset>\n

    ACC Information\n<\/h2>\n

    Facility Physical Address\n<\/h2>\n

    Facility Mailing Address\n<\/h2>\n

    Facility Contact Information\n<\/h2>\n

    <\/div>\n

    \n<\/p>

    <\/div>\n<\/form>\n<\/div>\n[\/vc_column][vc_column width=”1\/6″][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

    [vc_row][vc_column width=”1\/6″][\/vc_column][vc_column width=”2\/3″ css=”.vc_custom_1770410287832{background-color: #ffffff !important;}”][vc_column_text css=”.vc_custom_1770410319131{padding-bottom: 20px !important;}”] Inside of Service Area Affiliation Agreement Request Form [\/vc_column_text][vc_empty_space height=”1.5rem”][vc_btn title=”Return to Service Area” style=”custom” custom_background=”#003366″ custom_text=”#ffffff” size=”sm” link=”url:https%3A%2F%2Fsites.austincc.edu%2Fhealth%2Ffacstaff%2Faffiliation-agreement-request-service-area%2F|title:Affiliation%20Agreement%20Request%20Service%20Area||”][vc_empty_space height=”1.5rem”][\/vc_column][vc_column width=”1\/6″][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":450,"featured_media":0,"parent":1297,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1892","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/pages\/1892","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/users\/450"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/comments?post=1892"}],"version-history":[{"count":0,"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/pages\/1892\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/pages\/1297"}],"wp:attachment":[{"href":"https:\/\/sites.austincc.edu\/health\/wp-json\/wp\/v2\/media?parent=1892"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}