Oklahoma nurse practitioner supervising physician prescriptive authority change form 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out your personal information, including your RN license number, name, and contact details. Ensure that you type or use blue or black ink as required.
3. Indicate whether you are adding or deleting a supervising physician. For additions, complete the attached Agreement for Physician Supervising Advanced Practice Prescriptive Authority for each new physician.
4. For deletions, clearly write the full name of the supervising physician you wish to remove from your records.
5. Review all entries for accuracy. Remember that any corrections should not involve correction fluid; instead, retype if necessary.
6. Submit the completed form along with the $10 fee via check or money order to ensure processing within 14 days.

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