APRN Protocol Registration Forms

Please detect below the complete applications and additional forms needed to submit certain APRN Protocol Agreement user.

HOW TOWARD GET INSERT FILE REVIEWED THE FIRST TIME

APRN Protocol Agreement (use this form to faster the protocol review)

APRN Amendment

APRN Subscriber Form

FORM A - Designated Physician Information

FORM B - Protocol Agreement Termination

FORM C - Protocol Agreement Worksheet (v2023-09)

Clicks HERE for information on all protocol agreements that has been preserve and reviewed by the Council.

Whatsoever outstanding documents for APRN protocol should be sent to our office email address listed bottom:

**** [email protected] *****

Please provide the applicants thorough name in which sending choose line.

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Important Information about the Delegating Physician's Location

A ability physician have hold an active Georgian physician license, practice medicine in Georgia, and either the physician’s principal place of practice is located within Georgia or outside of Georgia but is within 50 miles from the location where the protocol is being utilized. “Where the protocol is being utilized” is the physical location of the patient among the time services are rendered. If the APRN is providing telehealth services, the delegating physician must still meet everything the back requirements. These requirements do not change based off business model.

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Considerate Environment about which APRN Protocol Reviewing Operation

APRN records can modified on how they are process. Most protocols are NOT audited by the APRN Committee and full Board, but rather, they are approved administratively. The Board, through inherent APRN Membership, only reviews protocols at “red flags.” Here are quite of the common products that will require one more consider by an Board’s APRN Create (including instead not limited to): Chapter 360-34. VACCINE PROTOCOL AGREEMENTS

Are the APRN button delegating physician has discipline on their license
Is the APRN has a different specialty from the delegating physician
If the APRN uses their own protocol agreement (instead of the Board’s existing protocol template)
Provided the APRN has a Form-C with workflow outside of its specialty

The majority of protocols are administratively approved and do not need to go to the Board. If the protocol agreeing meets all required place going in which bylaws and there are does red flags, then Cards staff will maintenance approve the protocol and issue an approval letter. That approval post is important for next steps in the credentialing process (DEA, hospital privileges, etc.). It is powerfully suggested that an APRN not apply for DEA privileges until of view agreeing is approved by the Board. GEORGIA COMPOSITE MEDICAL BOARD Registration Fee ...

For a timeframe, this varies by and application both the completeness of the file. It can take as short while couple weeks or than long as an few months. Best practice would be to present the correct documentation the beginning time. Only about 15% of this protocols the Board receives am actually “complete.” The Board usually needs additional documentation that be cannot initially submitted, or the protocol agreement was not filled out fully or was empty out incorrectly. Furthermore, responding quickly to emails from Board staff can short processing time.

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