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  • Ga Form C 2015

Get Ga Form C 2015-2025

ADDRESS: Phone#: CERTIFICATION INFORMATION: (PLEASE CHECK THE APPROPRIATE BOX) CERTIFIED NURSE MIDWIFE PSYCHIATRIC/MENTAL HEALTH SPECIALIST NURSE PRACTITIONER Procedures being performed by the APRN are within competency of their certification specialty. OR Procedures being performed by the APRN that are not within competency of their certification spec.

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How to fill out the GA Form C online

Filling out the GA Form C is a crucial process for advanced practice registered nurses (APRNs) and their delegating physicians. This guide provides step-by-step instructions to help you complete the form accurately online.

Follow the steps to fill out the form effectively.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling in the delegating physician’s name and license number. Ensure this information is accurate and legible.
  3. Next, input the APRN’s name and RN number. Similar to the previous step, this information must be filled out clearly.
  4. Provide the address and phone number for the APRN. This information is essential for contact purposes.
  5. In the certification information section, check the appropriate box to indicate the APRN's specialty: Certified Nurse Midwife, Psychiatric/Mental Health Specialist, or Nurse Practitioner.
  6. If procedures outside the normal scope are being performed, list them below the provided fields and include documentation of training and competency as per the instructions.
  7. After completing the required fields, ensure to have both the APRN and delegating physician sign and date the form. Remember that electronic signatures are not accepted.
  8. Once the form is complete, save changes, and use options to download or print the form for submission.

Complete your GA Form C online today to ensure proper compliance and documentation.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232