Introduction. The purpose of the collaboration between an academic entry level physical therapy program and tax assisted hospital physical therapy department was to provide an early OP introduction to second year DPT students consistent with their didactic course content and provide needed physical therapy services to indigent, underserved and uninsured individuals on the hospital waiting list. Case presentation. With reductions in hospital revenue and resulting decreasing physical therapy resources, the largest local district hospital was challenged by a long list of patients waiting for services and sought a solution. Deviation From the Expected. A contract relationship was established to provide a faculty member and student supervised services one day per week throughout the academic year in the hospital OP department. Discussion. Working with the local hospital PT Director and the university attorney, a designated faculty member developed a viable clinical education experience using a self-contained collaborative clinical model. Underserved clients from the “waiting list” with musculoskeletal diagnoses consistent with limited visit requirement and student knowledge are selected for the faculty/student OP clinic. The hospital has designated an area in the OP department for initial examination and evaluation with permission to use the OP gym area as needed. The supervising faculty assists with selection and scheduling of patients with a maximum 8/day. Hospital personnel contact and complete the patient registration process including required hospital intake paperwork. The patient is seen for an initial evaluation and a maximum of 3 follow-up visits, consistent with hospital policy. Clinic occurs once weekly during each academic semester. Conclusion. Patient satisfaction is high per hospital survey. Hospital staff reports less stress and pressure from administration as the patient waiting list is diminishing. An effective scheduling system was developed with students attending 2 weeks in a row for patient follow-up. With only patient name and physician diagnosis available, students are learning to expect the unexpected