Np-sample-collaborative-agreement 2025

1. Click ‘Get Form’ to open the np-sample-collaborative-agreement in the editor.
2. Begin by filling in the 'Name of RHC' at the top of the document, ensuring it reflects the correct agency or entity.
3. In the 'Scope of Practice' section, specify the nurse practitioner's specialty and any exceptions to their certified scope of practice.
4. Detail the 'Practice Protocols' by citing approved protocol texts and any additional relevant protocols that apply to this practice.
5. Complete the 'Physician Consultation' section by listing names for coverage and ensuring all parties are aware of their responsibilities.
6. Fill out the 'Record Review' section, indicating how often patient records will be reviewed and who will conduct these reviews.
7. Address potential disagreements in health management within the 'Resolution of Disagreements' section, specifying how conflicts will be resolved.
8. Finally, both parties should sign and date at the bottom of the agreement, confirming their understanding and acceptance of its terms.

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