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01. Edit your ohio physician assistant supervision agreement online
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How to use or fill out addendum supervision agreement application with our platform
- Click ‘Get Form’ to open the addendum supervision agreement application in the editor.
- Begin by filling in the supervising physician's name and their supervision agreement number. This information is crucial for linking the new physician assistant to the existing agreement.
- Next, provide the physician assistant's details, including their Ohio Certificate to Practice Number. Ensure accuracy as this will be verified by the State Medical Board.
- Each supervising physician must sign the affidavit section, confirming their commitment to supervise the listed physician assistants. Make sure all signatures are dated appropriately.
- Review all entered information for completeness and accuracy before finalizing your document. Utilize our platform’s editing tools to make any necessary adjustments.
- Once satisfied, save your completed application and follow the instructions for submission to ensure it reaches the State Medical Board of Ohio promptly.
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