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Get Pdf Fillable Capa Form
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How to fill out the Pdf Fillable Capa Form online
Filling out the Pdf Fillable Capa Form online is a straightforward process that requires careful attention to detail. This guide will walk you through each section of the form, ensuring you provide all necessary information accurately.
Follow the steps to complete the form online.
- Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
- Begin by entering your last name in the designated field under 'APRN Last Name'. Ensure you print clearly for readability.
- Next, input the last name of the physician you are collaborating with in the 'Physician Last Name' field, also making sure to print clearly.
- Proceed to fill out the 'APRN First Name' and 'Physician First Name' fields accordingly, again prioritizing clear printing.
- In the 'Kentucky APRN License #' section, provide your specific license number. Ensure this information is accurate.
- Complete the 'Population Focus' and 'Specialty' fields by indicating your areas of expertise.
- Enter your DEA number in the required field. Remember that you must provide a copy of your DEA license(s) from all states when submitting this form.
- Both you and the collaborating physician must sign above where indicated and include the date of signing.
- Fill in details about your practice, including the name, address, city, state, and zip code. Ensure all details are clear and correct.
- Lastly, provide a phone number including the area code for follow-up communication.
- After completing the form, you can save the changes, download it, print it, or share it as needed.
Take the next step and complete your online document submission today.
There are several reasons why you might not be able to fill in a PDF fillable form. The form may not have been created with fillable fields, or you could be using a software that does not support fillable features. If you're experiencing difficulties, consider using a different PDF editor that works well with Pdf Fillable Capa Forms.
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