Get Ny Nurse Practitioner Form Np-cr 2017-2026

Completing the NY Nurse Practitioner Form NP-CR is an essential step for certified nurse practitioners in New York who want to establish collaborative relationships. This guide provides clear, step-by-step instructions to help you accurately fill out the form online.

Follow the steps to successfully complete the NY Nurse Practitioner Form NP-CR.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Provide your name exactly as it appears on your current New York State Education Department issued nurse practitioner registration certificate(s).
3. Enter your nurse practitioner registration number(s) in the designated field.
4. Identify the nurse specialty area(s) of nurse practitioner practice in which you are certified by the New York State Education Department, choosing from the listed specialties.
5. By placing your initials in the specified area, attest that you are certified as a Nurse Practitioner in New York State and have more than 3,600 hours of experience practicing.
6. Initial in the appropriate space to affirm that you have collaborative relationships with licensed physicians or hospitals qualified to collaborate in your specialty area.
7. Initial again to confirm that you maintain current documentation supportive of your collaborative relationships and can produce evidence upon request.
8. Identify the name and license number of the physicians with whom you currently engage in collaborative relationships, including any relevant hospital information.
9. If desired, provide additional information regarding your collaborative relationships in the optional section.
10. Review the attestation statement regarding disputes and confirm the truthfulness of your provided information by signing and dating the form.
11. Once all fields are completed, save your changes, and choose to download, print, or share the form as needed.

Take the next step in your professional journey and complete the NY Nurse Practitioner Form NP-CR online today.