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How to use or fill out delegation agreement with our platform
- Click ‘Get Form’ to open the Delegation Agreement in the editor.
- Begin by entering the date at the top of the form. Ensure you fill in the month, day, and year accurately.
- In the Identification section, input the Physician Assistant’s name, signature, license number, and specialty. Repeat this for the Supervising Physician.
- For Physician Supervision, describe how supervision will be accomplished. Choose from options like on-site review or telecommunication.
- Indicate which patient services are delegated by marking 'yes' or 'no' for each item listed under Delegation of Medical Services.
- If applicable, specify any prescriptive practices in the Delegation of Prescriptive Practice section by selecting appropriate medication categories and controlled substances.
- Complete the Attest section by having both the Physician Assistant and Supervising Physician sign and date where indicated.
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