Prescriptive Authority Agreement Sample Contracts

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Prescriptive Authority Agreement Explanation Page
Prescriptive Authority Agreement • May 5th, 2020

This document is a template and should be used as starting point in developing a PAA that reflects the APRN(s)’ practice. All parties to the PAA should participate in the development. The delegating physician(s) must determine what medical acts he/she will delegate. The document should be reviewed, signed and dated at least annually. It may be done more frequently if needed. This template is specifically for nurse practitioners and clinical nurse specialists. CRNAs and midwives have other laws/regulations related to their practice which were not reviewed while constructing this document therefore not included.

Prescriptive Authority Agreement Advanced Practice Registered Nurses, and Physician Assistants
Prescriptive Authority Agreement • June 1st, 2015 • Texas
Contract
Prescriptive Authority Agreement • September 5th, 2019

My prescriptive authority agreement authorizes me to prescribe controlled substances. Do I need to do continuing education activities related to prescribing controlled substances?

Contract
Prescriptive Authority Agreement • May 29th, 2017
A BILL TO BE ENTITLED
Prescriptive Authority Agreement • November 12th, 2018
A BILL TO BE ENTITLED
Prescriptive Authority Agreement • March 10th, 2017
Family Nurse Practitioner Prescriptive Authority Agreement Example
Prescriptive Authority Agreement • July 21st, 2021

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Contract
Prescriptive Authority Agreement • May 5th, 2019
Prescriptive Authority Agreement
Prescriptive Authority Agreement • May 5th, 2020

Name: License Number: Type of Practitioner:(select one)  Advanced practice registered nurse Physician assistant *DEA Permit #: DEA Exp. Date: *DPS Permit #: DPS Exp. Date: Name of Practice Site Address Type of Practice Site #1 Site #2 Site #3

Prescriptive Authority Agreement Texas
Prescriptive Authority Agreement • May 12th, 2022 • Texas

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A BILL TO BE ENTITLED
Prescriptive Authority Agreement • January 7th, 2019
A BILL TO BE ENTITLED AN ACT
Prescriptive Authority Agreement • November 4th, 2015
Prescriptive Authority Agreement
Prescriptive Authority Agreement • October 30th, 2020

Name: License Number: Type of Practitioner: (select one)  Advanced practice registered nurse Physician assistant *DEA Permit #: DEA Exp. Date: *DPS Permit #: DPS Exp. Date: Name of Practice Site Address Type of Practice Site #1 Site #2 Site #3

Prescriptive Authority Agreement
Prescriptive Authority Agreement • March 2nd, 2017
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