Get Physician Assistant Application For Prescriptive Authority

This guide provides a comprehensive overview of how to effectively complete the Physician Assistant Application For Prescriptive Authority online. It is designed to help users understand each section of the application and ensure accurate submission.

Follow the steps to accurately complete your application.

1. Click ‘Get Form’ button to access the form and open it in your preferred document editor.
2. Read the instructions carefully. Confirm your eligibility to file this application based on your current Physician Assistant license status.
3. Select the reason for submitting the application. Indicate if you previously applied for a license or if you are reporting changes regarding supervisors or controlled substance schedules.
4. Indicate whether you are applying for prescriptive authority for controlled and non-controlled substances, or non-controlled substances only.
5. Provide your identifying and contact information. Fill in your full name, any other names used, mailing address, and contact phone numbers, including home and work.
6. List the location of each business or practice where you will be working in Delaware. Include the business name, location address, phone number, and email address.
7. For each practice location, indicate whether you will be prescribing controlled substances. Make sure to clarify for each site.
8. Enter the names of all supervising physicians who will oversee your practice. Make sure to arrange for these supervisors to submit a Statement of Supervising Physician.
9. Acknowledge your understanding that any changes in supervising physicians or schedules require a new application submission.
10. Complete the certification section by signing and dating the application to affirm its accuracy to the best of your knowledge.
11. Once completed, save any changes made, and consider downloading, printing, or sharing the form as needed.

Begin completing your Physician Assistant Application For Prescriptive Authority online today.