Change of Scope Application: Pain Medicine 2025

1. Click ‘Get Form’ to open the Change of Scope Application: Pain Medicine in the editor.
2. Begin by filling out your personal information in the designated fields, including your surname, given names, CPSO number, and date of birth. Ensure accuracy as this information is crucial for processing your application.
3. Complete the sections regarding your current and proposed practice structure. Clearly indicate the number of personnel you work with and describe any changes in your practice location.
4. Fill out the clinical activity section by providing details about your current and proposed patient management practices. Use the provided codes to categorize your activities accurately.
5. Review the requirements checklist included in the application package. Ensure that all necessary documents, such as your updated CV and evidence of training, are prepared for submission.
6. Once all sections are completed, sign the Clinical Supervision Agreement electronically within our platform before submitting it via email to cosre@cpso.on.ca.

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