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COLLABORATIVE PRACTICE AGREEMENT - Arkansas - arsbn arkansas 2026

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  1. Click ‘Get Form’ to open the COLLABORATIVE PRACTICE AGREEMENT in the editor.
  2. 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.
  3. 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.
  4. Fill in the protocols for prescriptive authority, specifying areas of educational preparation and certification for the APN. This ensures compliance with state regulations.
  5. Provide details about emergency coverage arrangements, including any associated hospital or clinic information. This section is vital for patient care continuity.
  6. 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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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.
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.
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.
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.
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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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).
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.
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,

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ASBN - Prescriptive Authority - Arkansas Department of Health

The Collaborative Practice Agreement must meet the following criteria: Must be complete and legible and on the current, unmodified form. The collaboratingRead more

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007.34.20 Ark. Code R. 003 - ASBN Rules: Chapter Four

Submit a collaborative practice agreement with a practicing physician who is licensed under the Arkansas Medical Practices Act, 17-95-201 et seq., or aRead more

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