Form ac1 pa adding alternate physicians form fillable 2026

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The document is a form (FORM AC1) used for adding alternate supervising physicians for a Physician Assistant (PA). It requires the primary sponsoring physician's information, the PA's details, and signatures from both. The form must be completed with specific information for each alternate physician listed and submitted to the Georgia Composite Medical Board.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Primary Sponsoring Physician’s Name, followed by their signature and license number. Ensure all details are accurate.
Fill in the Practice Address and the Physician Assistant's name, including their first, middle, and last names along with their license number.
The PA must sign and date the form in the designated areas provided.
For each alternate physician, complete every line with their name, license number, signature, and date signed. Remember that all fields must be filled; otherwise, your submission may be returned.
Once completed, save a copy for your records and ensure a copy is provided to the PA before submission.
Finally, return this form to the Georgia Composite Medical Board at the specified address.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (193 Votes)
2009	3.8 Satisfied (29 Votes)

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Can physician assistants practice independently in Pennsylvania?

Can a physician assistant practice independently? No, a PA cannot practice independently. Every PA must be supervised by a licensed physician (either M.D. or D.O.). The supervising physician is responsible for all medical services provided by the PA under their supervision and for following each patients progress.

Do physician assistants need a supervising physician in Pennsylvania?

Physician Assistants are permitted to independently prescribe under the supervision of a MD (allopathic) supervisor. The list of medications the PA cannot prescribe are listed in the work agreement approved by the board. PAs may prescribe scheduled II-V medications with an active DEA number.

Why cant PA work independently?

In what states can a PA open their own practice? The most PA friendly states when it comes to owning your own practice are Iowa, Montana, New Hampshire, North Dakota, Utah, and Wyoming. In other states with expanded scope of practice, physician assistants must collaborate with a physician in order to practice medicine.

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How many physician assistants can a physician supervise in Georgia?

(b) When acting as an alternate supervising physician, a physician may supervise as many as four physician assistants, who are working within the scope of practice of the alternate supervisor. 1. In an institutional setting, such as a hospital or clinic.

Does a PA require a supervising physician?

As a matter of law, a PA has no independent practice authority. Cannot make a diagnosis or order treatment plan for the patient. The PA can communicate that information to the patient on behalf of the physician. The PA has no independent practice authority.

Form ac1 pa adding alternate physicians form fillable 2026

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What is the simplest way to electronically sign my form ac1 pa adding alternate physicians form fillable?

How do you get form ac1 pa adding alternate physicians form fillable?

Can physician assistants practice independently in Pennsylvania?

Do physician assistants need a supervising physician in Pennsylvania?

Why cant PA work independently?

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How many physician assistants can a physician supervise in Georgia?

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Form ac1 pa adding alternate physicians form fillable 2026

Here's how it works

How to use or fill out form ac1 pa adding alternate physicians form fillable with our platform

See more form ac1 pa adding alternate physicians form fillable versions

Complete this form in 5 minutes or less

Got questions?

What is the simplest way to electronically sign my form ac1 pa adding alternate physicians form fillable?

How do you get form ac1 pa adding alternate physicians form fillable?

Can physician assistants practice independently in Pennsylvania?

Do physician assistants need a supervising physician in Pennsylvania?

Why cant PA work independently?

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People also ask

How many physician assistants can a physician supervise in Georgia?

Does a PA require a supervising physician?

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