Collaborative Prescribing Agreement Sample Contracts

Trelegy Ellipta®) and budesonide/glycopyrronium/formoterol fumarate (Breztri Aerosphere®) for moderate to very severe Chronic Obstructive Pulmonary Disease (COPD)
Collaborative Prescribing Agreement • November 7th, 2022

This Collaborative Prescribing Agreement (the "Agreement") is entered into by the Pharmaceutical Services Division, BC Ministry of Health, and the undersigned respirologist.

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Collaborative Prescribing Agreement
Collaborative Prescribing Agreement • January 8th, 2014

This COLLABORATIVE PRESCRIBING AGREEMENT (the CPA or "Agreement") is entered into by the Medical Beneficiary and Pharmaceutical Services Division, Ministry of Health, B.C., and the undersigned orthopaedic surgeon.

Collaborative Agreement for Advanced Practice Registered Nurse Prescriptive Authority for Non-Scheduled Drugs (CAPA-NS)
Collaborative Prescribing Agreement • July 25th, 2018

THIS COLLABORATIVE PRESCRIBING AGREEMENT (the "Agreement") is entered into this _____day of the month of ____________________in the year_______, by and between________________________________________________ APRN, herein after the "APRN", and___________________________________________ M.D., herein after the "Physician".

Contract
Collaborative Prescribing Agreement • April 10th, 2017

KBN & KBML Approved Collaborative Agreement for Advanced Practice Registered Nurse Prescriptive Authority for Non-Scheduled Drugs (CAPA-NS)

Collaborative Prescribing Agreement
Collaborative Prescribing Agreement • November 25th, 2019

For the prevention of acute and delayed nausea and vomiting due to highly-emetogenic cancer chemotherapy in combination with dexamethasone, for up to a maximum number of standard, planned treatment cycles of

Collaborative Prescribing Agreement
Collaborative Prescribing Agreement • July 11th, 2016

This COLLABORATIVE PRESCRIBING AGREEMENT (the "Agreement") is entered into by the Medical Beneficiary and Pharmaceutical Services Division (MBPSD), Ministry of Health, B.C., and the undersigned orthopedic surgeon.

Collaborative Prescribing Agreement
Collaborative Prescribing Agreement • July 14th, 2017

This Collaborative Prescribing Agreement (the "Agreement") is entered into by the Pharmaceutical Services Division, BC Ministry of Health, and the undersigned prescriber.

Collaborative Prescribing Agreement
Collaborative Prescribing Agreement • June 17th, 2011

This COLLABORATIVE PRESCRIBING AGREEMENT (the "Agreement") is entered into by the Pharmaceutical Services Division (PSD), Ministry of Health, B.C., and the undersigned prescriber.

Kentucky Board of Nursing and Kentucky Board of Medical Licensure Approved Collaborative Agreement for Advanced Practice Registered Nurse
Collaborative Prescribing Agreement • July 10th, 2015

WHEREAS, this Collaborative Prescribing Agreement is entered by and between the APRN and the Physician for the sole purpose of defining the scope of prescriptive authority to be exercised by the APRN, all in compliance with the applicable sections of KRS Chapter 314; and

Contract
Collaborative Prescribing Agreement • August 9th, 2017

Common Collaborative Agreement for Advanced Practice Registered Nurse Prescriptive Authority for Non-Scheduled Drugs (CAPA-NS) Form

Contract
Collaborative Prescribing Agreement • October 2nd, 2020

This agreement sets forth the terms of the Collaborative Practice Agreement (CPA) between the collaborative prescriber (Advanced Practice Nurse (APN) / Pharmacist) and (name of collaborating physician and specialty if any) at (name and address of agency or entity where practice takes place). This agreement shall take effect as of (date).

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