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FORM NP-CR Collaborative Relationships Attestation Form - op nysed 2026
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How to use or fill out FORM NP-CR Collaborative Relationships Attestation Form - op nysed
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your name exactly as it appears on your New York State Education Department issued nurse practitioner registration certificate.
- Next, provide your nurse practitioner registration number(s) in the designated field.
- Identify your specialty area(s) of practice by selecting from the provided options such as Acute Care, Family Health, or Pediatrics.
- Initial the attestation statements confirming your certification and experience, ensuring you have more than 3,600 hours of qualifying practice.
- Continue by initialing the section that confirms your collaborative relationships with licensed physicians or hospitals.
- List the names and license numbers of physicians you are currently engaged with in collaborative relationships.
- Optionally, provide any additional information regarding your collaborative relationships in the space provided.
- Finally, sign and date the form to complete your submission.
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