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Arkansas collaborative practice agreement

COLLABORATIVE PRACTICE AGREEMENT - Arkansas - arsbn arkansas 2026

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The document is a Collaborative Practice Agreement between an Advanced Practice Nurse (APN) and a physician (MD), outlining the terms of their professional collaboration. It specifies the physician's availability for consultation, the use of agreed protocols for prescriptive authority, and provisions for emergency coverage. The agreement serves to fulfill requirements for prescriptive authority as per the Arkansas Nurse Practice Act and is not intended as a business contract.

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Click ‘Get Form’ to open the COLLABORATIVE PRACTICE AGREEMENT in the editor.
Begin by entering the names of the Advanced Practice Nurse (APN) and collaborating physician (MD) at the top of the document. Ensure accuracy as this establishes the primary parties involved.
In the section regarding consultation and referral, confirm that both parties agree on communication methods, whether in person or electronically. This is crucial for effective collaboration.
Fill in the protocols for prescriptive authority, specifying areas of educational preparation and certification for the APN. This ensures compliance with state regulations.
Provide details about emergency coverage arrangements, including any associated hospital or clinic information. This section is vital for patient care continuity.
Attach a Quality Assurance Plan as required and ensure all signatures are collected at the bottom of the form from both parties, along with their respective license numbers and practice site details.

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Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (105 Votes)
2009	4.5 Satisfied (40 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Which states do not require NPs to be certified?

To date, these four states do not require NPs to be nationally certified. California. Nurse practitioners practicing in California may be able to get by without taking the national certification exam. New York. Kansas. Indiana.

Can nurse practitioners be self employed?

An NP who works in a state that requires physician supervision can still be self-employed. He or she can hire or contract physician supervisory services.

Can nurse practitioners work independently in Arkansas?

Act 412 of 2021 allows a pathway for certified nurse practitioners (CNPs) or clinical nurse specialists (CNSs) to apply for full independent practice after having practiced 6,240 hours under a collaborative practice agreement. Applications shall be submitted through the Arkansas Nurse Portal.

What is the purpose of a collaborative practice agreement?

Collaborative practice agreements allow for collaboration between physicians and advanced practice providers (APPs), such as physician assistants (PAs) and nurse practitioners (NPs). In many cases, collaboration agreements can improve care and healthcare access for patients.

Can a nurse practitioner practice independently in Arkansas?

Full Independent Practice for Certified Nurse Practitioners Act 412 of 2021 allows a pathway for certified nurse practitioners (CNPs) to apply for full independent practice after having practiced 6,240 hours under a collaborative practice agreement. Applications shall be submitted through the Arkansas Nurse Portal.

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How many nurse practitioners can a physician supervise in Arkansas?

Arkansas statute does not currently have a limit on how many PAs a physician can supervise but the state medical board enforces a policy limiting physicians to supervising no more than three PAs at once. Chart co-signatures are required (by the state medical board for the first 120 days of practice).

How to change name on nursing license in Arkansas?

Yes, you can request a name change as part of the renewal application process. Once you are in your Arkansas Nurse Portal account, from the General Information step under the demographics section, click the Request Name Change link.

In which states can NP practice independently?

Nurse Practitioners can practice independently in the 27 states with full practice authority: Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island,