UT DoC F-70aPA-D1 2026

1. Click ‘Get Form’ to open the UT DoC F-70aPA-D1 in the editor.
2. Begin by entering the Full Legal Name of the physician assistant in the designated fields for First, Middle, and Last names.
3. Fill in the Address section with the complete street address, city, state, ZIP code, and phone number.
4. In the Supervisor Information section, input the Name of Establishment and Supervisor's details including License Number and contact information.
5. Detail the Degree and Means of Supervision by describing how supervision will be provided when the supervising physician is unavailable.
6. Outline procedures for prescribing controlled substances if applicable, ensuring compliance with licensing requirements.
7. Complete sections on Scope of Practice and Emergency Situations by defining relevant procedures.
8. Finally, ensure both the Physician Assistant and Supervisor sign and date the form before saving it.

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