Prescription authority agreement: Fill out & sign online

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Click ‘Get Form’ to open the prescriptive authority agreement in the editor.
Begin by entering the names, addresses, and license numbers of both the delegating physician and the advanced practice registered nurse (APRN) or physician assistant (PA). This information is crucial for establishing accountability.
Specify the nature of practice and practice locations. Clearly outline where the APRN or PA will be operating to ensure compliance with regulations.
Identify the types or categories of drugs or devices that may be prescribed. You can select options like 'All dangerous drugs' or specify limitations as needed.
Detail your general plan for addressing patient emergencies and consultations. This section should include protocols for communication between the physician and APRN/PA.
Outline a quality assurance and improvement plan, including methods for documenting its implementation, such as chart reviews and meeting frequencies.
Finally, ensure all parties sign and date the agreement. Remember to maintain copies for both the physician and APRN/PA.

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