4np form 2026

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The document is a form (Form 4NP) from the New York State Education Department for Nurse Practitioners, detailing the process for verifying a collaborative agreement and practice protocol with a collaborating physician. It includes instructions for completing the form, sections for applicant and physician information, and requirements for submitting the form within 90 days of commencing practice.

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Click ‘Get Form’ to open the 4np form in the editor.
In Section I, complete your personal information. Ensure that item 4 has your name exactly as it appears on your Application for a Certificate (Form 1).
Proceed to Section II, where you and your collaborating physician must fill out their details. Make sure to include their name, address, telephone number, and New York State medical license number.
In Section III, select an approved practice protocol text from the provided list. Document the title, publisher, and publication date of this text.
Finally, both you and the collaborating physician must sign and date the form in Section III before submitting it to the Office of the Professions.

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Versions	Form popularity	Fillable & printable
2017	4.5 Satisfied (59 Votes)
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What is a nurse practitioner collaborative agreement?

In California, the collaborative practice agreement between a Nurse Practitioner (NP) and a physician must include standardized procedures, which are agreements on the scope of practice and protocols for patient care. These procedures are crucial for NPs to legally collaborate with physicians within the state.

Is an NP basically a doctor?

Collaborative practice agreements include provisions addressing: Patient referral and consultation. Coverage for emergency absences of either the NP or the collaborating physician. Resolution of disagreements between the NP and the collaborating physician regarding diagnosis and treatment.

How to apply for an NP license in NY?

graduated from a NP education program registered (approved) by NYSED as qualifying for an NP certificate. STEP 1: SUBMIT Online NP Form 1 - Application for Certification. You must pay the $85 license and first registration fee by credit card. STEP 2: HAVE YOUR SCHOOL (COLLEGE/UNIVERSITY) VERIFY YOUR NP EDUCATION.

What is a 4NP form?

Nurse Practitioners. License Application Forms: Nurse Practitioner. Form 4NP - Verification of Collaborative Agreement and Practice Protocol.

What is the purpose of a collaborative agreement for nurse practitioners?

Adult Acute Care Nurse Practitioner (ACNP) is considered one of the hardest nurse practitioner specialties due to the high level of patient acuity and the need for quick, precise decision-making in high-pressure environments.

4np sit

4np form template 4np form pdf 4np form online Nurse practitioner approved Protocol Texts 4NP site NP3 form np-cr form Collaborative Agreement Form

Do you need a collaborating physician in NY?

New York regulations require nurse practitioners to form a collaborative agreement with a physician until the NP has 3,600 hours of experience.