Common Collaborative Agreement CAPA-NS Form - KBN 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the date at the top of the form. This is essential for establishing the agreement's effective date.
  3. Fill in the names of both parties: the APRN and the Physician. Ensure that all names are spelled correctly to avoid any legal issues.
  4. In section two, specify the specialty area where the APRN will be prescribing. This should align with their scope of practice.
  5. Review sections three through five carefully, as they outline important legal stipulations regarding prescriptive authority and responsibilities.
  6. Complete the signature fields at the bottom of the form, ensuring both parties sign and include their license numbers for verification.
  7. Finally, input practice addresses and contact information accurately to facilitate communication between parties.

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Collaborative Agreement for Advanced Practice Registered Nurse. Prescriptive Authority for Non-Scheduled Drugs (CAPA-NS)
Collaborative Practice Agreement (CPA) refers to the formal written statement addressing the parameters of the collaborative practice which are mutually agreed upon by the advanced practice registered nurse (APRN) and one or more licensed physician(s) or dentist(s).
The American Board of Perianesthesia Nursing Certification (ABPANC), Certified Ambulatory Perianesthesia Nurse (CAPA) is for licensed registered nurses who care for patients who have experienced sedation, analgesia and anesthesia in a hospital or ambulatory care facility.
Here are the typical sections to include in a collaborating physician contract. Section #1: Scope of Practice. Section #2: Practice Protocols. Section #3: Physician Consultation. Section #4: Record Review. Section #5: Resolution of Disagreements. Section #6: Alteration of Agreement. Section #7: Compensation.
There are four types of APRNs. These include: nurse practitioners, certified nurse midwives, certified registered nurse anesthetists and clinical nurse specialists.
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Doctorate in Nursing (PhD or DNP): A doctorate is the highest level of nursing education. A PhD focuses on research and advancing nursing knowledge, while a Doctor of Nursing Practice (DNP) is practice-focused, preparing nurses for the highest clinical positions or leadership roles.

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