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How to fill out the *TEMPLATE* Collaborative Practice Agreement for Advanced Practice Nurses online
This guide provides you with a clear and supportive approach to filling out the *TEMPLATE* Collaborative Practice Agreement for Advanced Practice Nurses. By following these steps, you can ensure that all necessary information is accurately completed and submitted online.
Follow the steps to successfully complete the agreement.
- Click ‘Get Form’ button to access the document and open it in your preferred online editor.
- In the first section, provide the complete names, home and business addresses, zip codes, and telephone numbers for both the licensed practitioner and the advanced practice nurse. Ensure that each is filled out fully and accurately.
- List all locations where prescriptive authority is granted under this agreement. Include the business street address, city, state, zip code, and business phone number for each location.
- Detail the specialty and board certifications held by both the licensed practitioner and the advanced practice nurse. Indicate their qualifications clearly, using the appropriate titles and specialties.
- Describe the collaborative working relationship between the licensed practitioner and the advanced practice nurse. Highlight how they will work together, share responsibilities, maintain geographic proximity, and provide coverage during absences.
- Identify any limitations placed on the advanced practice nurse’s prescriptive authority by the licensed practitioner. Be specific about whether or not there are any additional constraints.
- Explain the review process for the advanced practice nurse's prescribing practices by the licensed practitioner. Include timeframes and the types of documentation required.
- List any other written practice agreements between the licensed practitioner and the advanced practice nurse. State whether there are any existing agreements or detail them as necessary.
- Specify the duration of the written practice agreement. Note that either party may terminate the agreement without cause at any time, effective immediately upon notification.
- Finally, secure signatures from both the licensed practitioner and the advanced practice nurse, along with the respective dates of signing.
- After completing all sections of the form, review your information for accuracy. Save changes, download the document, print a copy, or share as needed.
Complete your Collaborative Practice Agreement online today for a smooth and efficient process.
A collaboration agreement should include the objectives of the collaboration, the specifics of roles and responsibilities, and a plan for regular evaluations. It is important to specify any legal requirements or guidelines to ensure compliance. Using a TEMPLATE Collaborative Practice Agreement For Advanced ... - In can help you ensure that all vital components are covered efficiently.
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