Get Model Form For The Development Of A Prescribing Agreement

Filling out the Model Form For The Development Of A Prescribing Agreement is a critical process for advanced practice registered nurses (APRNs) wishing to prescribe medications or devices. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently online.

Follow the steps to successfully complete the prescribing agreement form.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by filling out the credentials section for both the APRN and the physician. This includes entering the names, degrees, certifications, specialties, and relevant experience.
3. In the section describing the patient population, check the appropriate boxes that represent the settings where the APRN will practice, including options such as clinic, hospital, and long-term care. Specify the ages and types of conditions of the patients served.
4. Detail the prescriptive authority by indicating the categories of drugs and therapeutic devices the APRN may prescribe. Ensure to note any limitations or exceptions, and provide a complete list of drug categories if necessary.
5. Complete the section describing the termination or suspension of the agreement. Write how continuity of care will be maintained for patients if the agreement is terminated.
6. Fill in the renewal requirements, agreeing to review and sign the document at least annually. Include the specific date for the next review.
7. Finally, ensure both the APRN and physician sign and date the form. Double-check all sections for completeness and accuracy.
8. Once all fields are completed, save your changes. You may choose to download, print, or share the form as needed.

Start filling out the Model Form For The Development Of A Prescribing Agreement online today.