Get Suny Upstate University Hospital Nurse Practitioner Collaborative Practice Agreement 2012-2026

Filling out the SUNY Upstate University Hospital Nurse Practitioner Collaborative Practice Agreement online is essential for establishing a collaborative framework between nurse practitioners and their collaborating physicians. This guide provides clear, step-by-step instructions to help users navigate the process efficiently and accurately.

Follow the steps to fill out the agreement with confidence.

1. Click ‘Get Form’ button to obtain the agreement and open it in your preferred editor.
2. In the first section, fill in the names of the Nurse Practitioner and Collaborating Physician. Ensure the professional titles are accurate and reflect current certifications.
3. Provide the place of business address at Upstate University Hospital or Upstate University Hospital at Community General, ensuring that all details are correct.
4. In the Practice Agreement section, review the outlined services to be performed by the Nurse Practitioner. Verify that the services align with your scope of practice.
5. Complete the Scope of Practice section by confirming that the Nurse Practitioner has the necessary qualifications and certification as described. Include relevant details about prescriptive privileges.
6. Review the Physician Consultation provisions and confirm that the Collaborating Physician’s availability is articulated clearly, including both on-site and telephone access.
7. Address the Provisions of Emergency Coverage by designating a backup Physician for emergency situations in the absence of the primary team.
8. In the section regarding Resolution of Disagreements, outline the process for conflict resolution, ensuring all parties understand the arbitration protocol.
9. Finalize the document by acknowledging that the Practice Agreement will be reviewed annually and can only be modified in writing. Make a note of this for future reference.
10. Both the Nurse Practitioner and Collaborating Physician should sign and date the agreement in the respective spaces provided, confirming their understanding and commitment.
11. Once completed, save your changes. You may choose to download, print, or share the form as needed.

Start filling out your Nurse Practitioner Collaborative Practice Agreement online today to establish effective collaboration.