Get State Medical Board Of Ohio Physician Assistant Supervision Agreement Instructions Read All

This guide provides comprehensive instructions for completing the State Medical Board of Ohio Physician Assistant Supervision Agreement. By following these steps, users can efficiently fill out the form and ensure compliance with the board's requirements.

Follow the steps to complete the supervision agreement addendum.

1. Press the ‘Get Form’ button to obtain the agreement form and open it in your preferred editing tool.
2. Review the instructions carefully to understand the purpose of the addendum, which is to add a newly hired physician assistant to existing supervising physicians with active supervision agreements.
3. Identify any supervising physicians with active agreements. Ensure that they are prepared to fill out the form, including providing their names, license numbers, and supervision agreement numbers.
4. All supervising physicians must sign the affidavit of supervising physician signature sheet. Each physician must print their name, provide their physician license number, supervision agreement number, and sign the form with the date.
5. Have the physician assistants who will be added review and sign the physician assistant affidavit, ensuring they acknowledge the duties outlined in the original supervision agreement.
6. Finalize the form by confirming that all required fields are completed correctly. Double check all signatures and information for accuracy.
7. Once completed, users can save changes, download, or print the form as needed. The completed application should be mailed to the State Medical Board of Ohio at the designated address.

Begin filling out your supervision agreement online today.