Il486 1881-2026

1. Click ‘Get Form’ to open the il486 1881 document in the editor.
2. Begin by entering the name of the advanced practice nurse in the designated field. Ensure that you provide accurate information as this will be used for official records.
3. Fill in the date of birth and social security number. This information is crucial for identification purposes and must be entered correctly.
4. Complete the address section, including street, city, state, and zip code. Double-check for any typos to avoid delays in processing.
5. In the section regarding prescriptive authority, check the appropriate boxes for Schedule II, III, IV, or V controlled substances as applicable. Make sure this aligns with your collaborative agreement.
6. Finally, have the collaborating physician sign and date the form. This signature is essential to validate the delegation of authority.

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