After signing a collaboration agreement, most states require follow-up steps to stay compliant. Skipping these can lead to fines or delays.
Know the difference:
Submission Only: Some states let you start once the agreement is submitted.
Approval Required: Others make you wait for board approval before practicing.
State-Specific Rules: Some need notarization, mailed forms, or proof of delivery.
This content is for general informational purposes only and is not legal advice. Requirements vary by state and may change over time. Always review your state’s official licensing board guidance and contact the board directly to confirm the most up-to-date and applicable rules for your collaboration agreement and ongoing compliance.
Nurse Practitioner
The Board of Medical Examiners and the Board of Nursing jointly approve applications for approval of collaborative practices between qualified physicians and CRNPs and/or CNMs. This must include the Standard Protocol, the QA plan, and the commencement of collaborative practice form.
The COLLABORATING PHYSICIAN must initiate the process:
-Apply for approval of an initial collaborative practice through your Licensee Portal
-Log in using your last name and last five digits of your SSN
-Scroll down to "Apply for Collaborative Practice" and click the "Apply CP" button
-Review instructions and rules regarding collaborative practices, click "Next" to review screen guide, and click "Next" to enter application information
-Complete application and make payment
Upon successful completion, the CRNP or CNM's name will appear in the "License Information" section of your Licensee Portal (https://www.albme.gov/uploads/pdfs/Commencement_of_Collaborative_Practice_Licensee_Portal_Instructions.pdf)
CRNP/CNM:
Apply to Alabama Board of Nursing (ABN) for approval of an initial or modified collaborative agreement. For controlled substance prescribing, NPs and PAs must obtain a QACSC.
Physician Assistant
All forms must be submitted to the Alabama Board of Medical Examiners.
The collaborating physician and physician assistant will fill out the Application for Registration of Physician Assistant (required).
The collaborating physician will fill out the Physician Assistant Core Duties and Scope of Practice (required).
The collaborative physician will complete the Disclosure of Existing Supervisory and Collaborative Agreement form (required).
The president, chairman, or CEO will complete the Supplemental Certificate of Hospital/Corporate Employer (if applicable). If the physician assistant will be prescribing medications, the collaborating physician and physician assistant will complete the Formulary for Non-Controlled Prescribing (if applicable).
The covering physician will complete the Covering Physician Agreement (if applicable).
For physician assistants practicing in Adult Gerontology, Family Medicine, General Medicine, or Primary Care, the Limited Protocol for Comprehensive Physical Exam must be completed.
Physician Assistants
Physician Assistants must submit the collaborative plan to the board. The collaborative plan
is valid when it is approved by a representative of the board and it is noted on the PA's temporary permit or permanent license.
State law requires that a copy of this approval plan be available for review by the public at the place ofo employment.
Nurse Practitioner
An Advanced Practice Registered Nurse (APRN) with Prescriptive Authority must have a current updated Collaborative Practice Agreement (CPA) on file with the Board of Nursing. APRNs should keep their original CPA and submit a copy (PDF) to the Arkansas State Board of Nursing (ASBN) through the Arkansas Nurse Portal message center.
The APRN is responsible for ensuring this requirement is met. After review of any new CPA, the APRN will be contacted through the Nurse Portal that the CPA has been approved or it has been denied and the reason for the denial. You may NOT practice under a CPA until you receive an approval letter.
Physician Assistant
The delegation agreement must be submitted to the Board delineating the scope of practice that the physician assistant will engage in, the program of evaluation and supervision by the supervising physician.
Additional forms are required to be submitted for prescriptive authority in Colorado:
-- Required forms: Prescriptive Authority - New Application (Apply Online)
-- Prescriptive Authority - Online Application ChecklistProposed Mentorship Form
-- Provisional to Full RXN Application (post 750 hour Colorado Mentorship)
-- Prescriptive Authority - Reinstate Expired Authority (Apply Online)
-- Prescriptive Authority - Online Reinstatement Application Checklist
All forms can be found here:
Nurse Practitioner
A physician must submit notice to the Board when he/she enters into a formal supervisory relationship or standing orders with an emergency medical technician or paramedic licensed pursuant to s. 401.27, which relationship or orders contemplate the performance of medical acts, or an established protocol with an advanced registered nurse practitioner, which protocol contemplates the performance of medical acts identified and approved by the joint committee pursuant to s. 464.003(2) or acts set forth in s. 464.012(3) and (4), the physician shall submit notice to the board. The physician shall file notice within 30 days of entering into the relationship, orders or protocol. Additional information regarding protocols can be found at s. 458.348, F.S.
Notice shall also be filed within 30 days after terminating the relationship, orders, or protocol, which can be found here in this form:
Mail the completed Protocol Form to:
Department of Health - Division of Medical Quality Assurance | Board of Medicine
4052 Bald Cypress Way, Bin C03
Tallahassee, FL 32399-3253
(850) 488-0596 FAX
Physician Assistant
Florida law requires Physician Assistants (PAs) to notify the Board in writing within 30 days after employment, or after any subsequent change in the supervising physician by submitting the Supervision Data Form.
Nurse Practitioner
All Nurse Protocol Agreements between APRNs and collaborating physicians must be submitted to the Georgia Composite Medical Board (GCMB) before the APRN begins practicing. Submission must occur within 30 days of signing by both parties.
Fee & Payment: $150 registration fee.
As of July 7, 2025, APRN Protocol agreements must be submitted through the ThoughSpan Licensing Gateway. See full instructions here.
A checklist is available here for completing the APRN Protocol document.
Required Documentation:
Completed Nurse Protocol Agreement, including:
-- Delegation of medical acts
--Scope of practice for the APRN
--Prescriptive authority details (if applicable)
--Any additional documents required by the GCMB
Prescriptive Authority Registration:
If prescriptive authority is included, the agreement must specify the medications the APRN is authorized to prescribe in compliance with Georgia law.
Physician Assistants
To add or change a primary supervising physician, the applicant must submit an Add/Change Supervising Physician Assistant Application and a Basic Job Description.
Depending on the circumstances of the PA, they may also need to submit Form B (Request for Additional Duties); Form H (Separation Notification Form), or Form J (Specific Power of Attorney). These forms can either be uploaded to egov or emailed to [email protected].
Physician Assistants
The Verification - Supervising Physician form must be mailed to:
DCCA PVL Licensing Branch
PO Box 3469 Honolulu, HI 96801
Nurse Practitioner
Notice of Delegated Prescriptive Authority for Controlled Substances
(APRN-CS) must be submitted by the COLLABORATING PHYSICIAN if the collaborating physician is delegated prescriptive authority of controlled substances to the APRN.
Physician Assistant
Notice of Delegated Prescriptive Authority (PHA-CS) must be submitted by the COLLABORATING PHYSICIAN if the collaborative physician is delegating prescriptive authority of controlled substances to the physician assistant. SCHEDULE AUTHORITY IS NOT EFFECTIVE UNTIL THE LICENSE IS ISSUED.
Nurse Practitioner
Before Initiating Prescriptive Practice APRNs must submit the Collaborative Practice Agreement to the Indiana State Board of Nursing before they begin prescribing medications. The agreement should include original signatures from both the APRN and the collaborating physician. (in.gov)
If there are any changes to the Collaborative Practice Agreement or if it is terminated, the APRN is required to notify the Indiana State Board of Nursing immediately in writing. APRNs must also apply for prescriptive authority.
The APRN instructions for submission can be found here.
Mail or email the form, with the cover sheet to:
Professional Licensing Agency 402 West Washington Street Room W072 Indianapolis, IN 46204
Email:
Physician Assistants
Physician Assistants must submit their collaborative agreement to the Board for approval. PAs can email the agreement to the board at [email protected].
If they are changing or adding a new collaborative physician other than the physician initially listed on their license, they must submit a Change and Addition of Collaborating Physician Application. They will also need to submit an application fee of $50 payable to the Professional Licensing Agency and the collaborative agreement.
Physician Assistant
Physician assistants must submit a Physician Assistant Active Practice Request Form and Written Agreement to the board.
Nurse Practitioner
The CAPA-NS form must be completed by the collaborating physician and the nurse practitioner.
The CAPA-CS form must be completed by the collaborating physician and nurse practitioner
and be approved by the Kentucky Board of Nursing.
Physician Assistant
The collaborating physician must submit an Application to Supervise a Physician Assistant
to the Kentucky Board of Medical Licensure, which must be approved by the board before the physician assistant may practice under the supervising physician.
Nurse Practitioner
The APRN must notify the Louisiana State Board of Nursing (LSBN) in writing within 30 days of all changes regarding prescriptive authority including requesting the addition or deletion of collaborating physician(s) or dentist(s) and sites.
This form must be submitted, along with the collaboration agreement.
Physician Assistants
Physician assistants must submit a "PA Notice of Intent to Practice" to the board and obtain approval by the board to practice. Collaborating physicians must complete a "Registration as a Supervising Physician" on the Louisiana State Board of Medical Examiners website.
Nurse Practitioners
For Nurse Practitioners practicing for under the twenty-four month supervision requirement, the Board must receive the Application for Approval of a Supervising Relationship with a Licensed Physician or Nurse Practitioner, fee, and letter from the physician /nurse practitioner of his/her intent to supervise you within 15 days of beginning employment. The letter must be on letterhead, include information on what services you will be providing, patient population, hours per week and anticipated start date. If you are terminating a supervisory relationship, or modifying/changing a supervisory relationship an Application for Approval of a Supervising Relationship with a Licensed Physician or Nurse Practitioner must also be filed.
Physician Assistants
Physician assistants with more than 4,000 hours of documented clinical practice as determined by the Board and who are the principal clinical provider without a physician partner or who own and/or operate an independent practice must have the following in order to render medical services under their Maine license:
(1) A Board-approved practice agreement with a Maine physician holding an active, unrestricted physician license.
Physician Assistants must submit an Application for Approval of Collaboration or Practice Agreement.
Physician Assistants
PAs are required to inform the Maryland Board of Physicians about the executed Collaboration Agreement before starting their practice. This notification is done via the Licensed Practitioner Portal: mbp.state.md.us
Instructions: To access the portal, visit the Maryland Board of Physicians' website.
Log in using your full 8-character license number (e.g., D0012345) and password.
If you haven't registered yet, select "New Registration" to create an account.
View the instructions from the Board of Physicians in Maryland here.
Nurse Practitioner
Nurse practitioners must apply for prescriptive authority in Massachusetts.
Nurse Practitioner
The collaborating physician is required to complete the "Collaboration Information Form" for each APRN they collaborate with. This form captures essential details about the physician, the APRN, and the practice setting. The form can be accessed here.
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Completed forms should be submitted via the MSBML's online licensure gateway.
Physician Assistants
Before practicing in Mississippi, a Physician Assistant (PA) must submit their practice information to the Board through MELS website.
Here are directions on how to do so.
Nurse Practitioner
For Nurse Practitioners who will be prescribing controlled substances in Missouri, the
collaborative physician must submit a Notice of Delegated Prescriptive Authority for Controlled Substances. The Nurse Practitioner must submit a Controlled Substance Prescriptive Authority Application to the Missouri Board of Nursing. The nurse practitioner must also submit a Statement of Preceptorial Experience and Statement of Practice in APRN Category to the Board of Nursing.
Collaborative Physicians must submit Collaborative Practice Agreement/Arrangement Change Form for new NP collaborations.
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Physician Assistant
For physician assistants who will be prescribing controlled substances in Missouri, the collaborative physician and physician assistant must submit an Application for Certificate of Controlled Substances for Prescriptive Authority for approval by the board.
Within thirty days of any change and on each renewal, the state board of registration for the healing arts shall require every physician to identify whether the physician is engaged in any collaborative practice arrangement, including collaborative practice arrangements delegating the authority to prescribe controlled substances, and also report to the board the name of each physician assistant with whom the physician has entered into such arrangement through the Physician Assistant Collaborative Practice Arrangement Form.
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Nurse Practitioner
A physician intending to collaborate with an APRN must notify the Nevada State Board of Medical Examiners before the collaboration begins. This notification should include the names and practice locations of both the physician and the APRN, as well as details about the collaborative practice. The notification form requires signatures from both parties.
This form, along with the collaboration agreement must be notarized and submitted.
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Physician Assistant
A physician intending to collaborate with a physician assistant in Nevada must submit a
Notification to Nevada State Board of Medical Examiners of Supervision of Physician Assistant
and must be notarized.
Nurse Practitioner
Newly certified nurse practitioners (NPs) are required to file with the New York State Education Department (SED) FROM 4NP ; "Verification of Collaborative Agreement and Practice Protocol" within 90 days after starting professional practice.
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Nurse Practitioner
Nurse practitioners who have not practice in North Carolina in the past must submit an "Initial Approval to Practice". This is an online application that must be completed and approved by the North Carolina Medical Board and Board of Nursing prior to beginning employment as a NP. An approval number will be given to the NP, and must be included on all prescriptions written by the NP. If the NP is working with a new collaborative physician they must submit a "Renewal Approval to Practice" for approval.
Every NP who prescribes controlled substances must enroll and utilize the Controlled Substances Reporting System (CSRS) within 30 days after obtaining an initial or renewal approval to practice that confers the authority to prescribe a controlled substance for providing medical care for a client.
Physician Assistant
Physician assistants must submit an online Intent to Practice form via NCMB's online Licensure Gateway portal to designate the primary supervising physician. Forms can be accessed here.
Nurse Practitioner
Nurse Practitioners must update the board with the name and business address of each collaborative physician within 30 days.
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Nurse Practitioner + Physician Assistants
Advanced Practice Registered Nurses (APRNs) seeking prescriptive authority must submit their collaborative agreement to the board.
Instructions:
Complete the "Agreement for Physician Supervision Advanced Practice Prescriptive Authority" form.
The completed agreement must be notarized.
Upload the completed form to your Nurse Portal account for each current Supervising Physician when:
Renewing prescriptive authority every two years
Adding supervising physician(s) for previously granted prescriptive authority
Applying for new prescriptive authorityReinstating prescriptive authority
File any changes to the written statement with the Board within thirty (30) days of the change
Nurse Practitioner
In Pennsylvania, Certified Registered Nurse Practitioners (CRNPs) must file their prescriptive authority collaborative agreement with the Bureau of Professional and Occupational Affairs.
Instructions:
Keep the original agreement at the CRNP's primary practice location.
File a copy with the Bureau of Professional and Occupational Affairs.
Notify the Board in writing whenever the agreement is updated or terminated.
When appropriate, file the "Change Of Prescriptive Authority Collaborative Agreement" form and the amended agreement with the Board.
All forms can be found here: Certified Registered Nurse Practitioner and Prescriptive Authority
Physician Assistant
The physician assistant or collaborative physician can initiate the Written Agreement. If the physician assistant is initiating the agreement, they will go into the PALS website using their User ID and Password. Under Professional License Details, click on the green pencil icon next to your license number. On the Change Options (License) pop-up, select Written Agreement. Complete the application and enter the Primary Supervisor License Number.
Once the PA confirms the agreement, it will be sent to the supervising physician. The supervising physician must approve the application, and then the application must be submitted to the board.
Applications will remain in "Submitted" status until they are evaluated and approved by the board.
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Nurse Practitioner
APRNs in South Carolina must submit an APRN Change of Practice Form for any new employment, change of practice, or new collaborating physician.
To obtain prescriptive authority, the APRN must submit an APRN Prescription Authority Application by mail to the South Carolina Board of Nursing -- 110 Centerview Drive, Columbia, SC, 29210
Physician Assistant
Physician Assistants must submit a Supervisory Agreement Form and Scope of Practice Guidelines Addendum Form through the portal for approval by the Board.
Nurse Practitioner
Prior to prescribing medications, APRNs are required to submit the "Notice and Formulary" form to the Tennessee Board of Nursing. This form provides details about the APRN, the collaborating physician, and the agreed-upon prescriptive authority. The form must be signed by both the APRN and the supervising physician.
You can find a copy of the required form here:
ADVANCED PRACTICE NURSE NOTICE AND FORMULARY
It can be mailed here: Tennessee Board of Nursing 665 Mainstream Drive Nashville, TN 37243.
If you are prescribing controlled substances, you must also register for the Controlled Substance Monitoring Database, and the supervisory relationship must be confirmed in the CSMD. The supervisee must enter the supervisor's driver's license number. The physician to whom the driver's license belongs will be notified at the time of their next log0in to the CSMD that there are supervisees awaiting approval.
Physician Assistant
The supervising physician must complete Attachment 4 and 5 and submit to the State of Tennessee Department of Health.
You may mail it to: 665 Mainstream Drive, Nashville TN, 37243.
If you are prescribing controlled substances, you must also register for the Controlled Substance Monitoring Database, and the supervisory relationship must be confirmed in the CSMD. The supervisee must enter the supervisor's driver's license number. The physician to whom the driver's license belongs will be notified at the time of their next login to the CSMD that there are supervisees awaiting approval.
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Nurse Practitioner + Physician Assistant
The supervising physician is responsible for registering the APRN in the TMB’s Online Supervision and Prescriptive Delegation Registration System. No paper submissions are accepted.
Supervision/delegation approval or termination changes should be updated in the TMB system within 30 days.
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Physician Assistant
The Supervising Physician must complete the Supervising Physician Application and submit the form along with "Application Form for Change in Supervision for Physician Assistant."
Once the form has been submitted, allow 10 business days for the supervising agreement to be approved by the Physician Assistant Advisory Council and Board officers. The physician assistant must submit a "Changes or Additions in Supervision" form along with their NCCPA certificate, the Supervising Application Form, and a $100 fee, if applicable.
This form must be notarized. This application must be approved by the board before the physician assistant can practice.
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Nurse Practitioner
Nurse Practitioners must submit the Collaborative Agreement Form Provided by the WV Nursing Board to the Board. The agreement must be notarized by the APRN and the Collaborative Physician. The original agreement must be mailed to the board office.
WV Board of Examiners for Registered Professional Nurses,
5001 MacCorkle Avenue SW,
South Charleston, WV 25309
Physician Assistant
Physician Assistants must notify the board within writing within 10 days through a Practice Notification of the collaborative relationship. A Practice Notification shall be completed on a form provided by the Board and shall be accompanied by an appropriate. The fee for practice notification is $100. The physician assistant may not commence practice until the board provides written notification to the physician assistant that a complete practice notification has been filed with the Board. There is no specific form that has to be submitted as notification.
Disclaimer: The information provided on this site is for general informational purposes only and is not intended to constitute legal, regulatory, or professional advice. No attorney-client or advisory relationship is created by your use of this content. Compliance requirements vary by state and are subject to change. You are solely responsible for verifying all applicable laws, regulations, and board requirements with your state licensing authority. Always consult qualified legal counsel before making decisions that may impact your legal or professional obligations.
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