What is a "site of practice?"

A site of practice (SOP) is a location where you practice medicine. As a faculty clinician at the UW School of Medicine you have limitations on your clinical practice, including where you can practice without prior approval.

Do I need site of practice approval?

All sites of practice, including any at which you engage in volunteer activities, must be approved by the dean through an approval process. Review of proposed off-site clinical practice is required to assure you are covered by the University’s professional liability program when providing clinical care to patients.

The medical malpractice liability coverage provided for you through the University and practice plan will only apply to approved sites of practice where you are practicing in your capacity as a University of Washington faculty clinician.

Note: UW Medicine, Seattle Children’s and affiliated facilities are pre-approved (see list below) and no further approvals are required.

Clinical practice is defined as “the type of services for which a Washington state professional health care credential (e.g. MD, MP, PA) is required.”

Some activities where site of practice approval is required:

  1. The delivery of clinical health care to a patient. This includes direct clinical contact and care of the patient, laboratory, pathology or radiology services associated with a specific patient’s care, or providing individual medical consultation or advice to a patient.
  2. Directing other health care professionals in their treatment of an individual patient.
  3. Medical Director services to a clinic, facility, or site in which health care services are provided.

Some activities where site of practice approval may not be required:

  1. Direct patient care vs. observation. If it's observation only, then no site of practice is required. But if there is work on protocols or other clinical procedures, there may be some risk and it's better to seek SOP approval.
  2. Research. If the activity is research, the SOP review is not required. But if there is clinical work outside of research, then SOP approval is required.

Patient Residential Sites

Under certain conditions, SOP approval is not required for Patient Residential Sites. See the Patient Residential Site Visit Policy for further information. 

“Patient Residential Sites” include, but are not limited to, personal residences, adult family homes, assisted living facilities, skilled nursing facilities, and other licensed care facilities,  where a patient resides. Patient Residential Sites do not include hospitals, hospital-based clinics, or freestanding physician clinics.

How do I get a site of practice approved?

Follow these steps to request site of practice approval:

  1. Complete a Site of Practice Proposal Submission Form (online Catalyst survey) 
  2. You must have concurrence from your division head for this activity
    • The department chair will not sign off on a SOP proposal without DH approval
    • Print SOP proposal and send with DH concurrence to DOM AHR (ksvend@uw.edu)
  3. Prepare accompanying documents, if required (foreign indemnification letter, proof of insurance, clinical contract)
  4. The SOP office will contact the department for concurrence from the chair
  5. The SOP office will contact you if there are questions or they require more information/documentation
  6. Wait for approval notification 


  • The SOP committee requests receipt of proposals at least one month prior to commencement of the proposed activities
  • The SOP Committee meets as necessary on the fourth Monday of the month
    • Unless very complex, most SOPs are approved by the committee via e-vote
    • If all materials are submitted with the proposal, it can be approved in less than a week. If urgent, a few days.  

Working outside the United States

There are extra considerations when requesting SOP approval at a foreign site. The SOP committee will need one of the two template letters (below) completed prior to review of this proposal. One letter states the hospital agrees to provide liability insurance, the other letter confirms that local malpractice insurance is not required for this activity.

Template letters

  1. Foreign Liability Coverage
  2. Foreign Liability Coverage not required by law

To find out which letter to request from the site where you are requesting SOP approval, please consult this list of Known Professional Liability insurance Requirements, by Country to see if the site accepts UW insurance.

Pre-approved sites of practice

The following are pre-approved sites that do NOT require sites of practice approval.

  • Eastside Specialty Center
  • Hall Health Primary Care Center
  • Harborview Medical Center (includes: Cleveland Harborview Health Center, Madison AIDS Clinic)
  • Northwest Hospital
  • North Seattle Surgery Center
  • Procure Proton Radiotherapy Center
  • Puget Sound Blood Center
  • Seattle Cancer Care Alliance inpatient hospital and outpatient hospital-based clinics (SCCA affiliated or network sites require separate Site of Practice approval)
  • Seattle Children’s Hospital / Children’s Bellevue, Everett, Federal Way, Olympia, Tri Cities (includes: Odessa Brown, Stanley Stamm Summer Camp, Seattle Children’s Pediatric Cardiology of Alaska Clinic)
  • Sports Medicine Clinic
  • University of Washington Medical Center
  • UW Intercollegiate Athletics
  • UW Medicine Neighborhood Clinics
  • Valley Medical Center
  • VAPSHCS – American Lake
  • VAPSHCS - Seattle

Site of practice vs. outside work for compensation

A site of practice approval is required for clinical work. If the activity is paid, a clinical contract may also be required. If a new contract is needed, this will be addressed during the SOP process. If the activity is paid, non-clinical work, you should go through the 1460 (outside work for compensation) process. For more on this, visit the outside work for compensation page.