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Backup supervising physician(s) form (do not send this form to the boards) name of nurse practitioner: keep a copy of this ...
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What is back-up supervising physicians form?
The back-up supervising physicians form is a document that designates a secondary physician to supervise medical activities in case the primary supervising physician is unavailable.
Who is required to file back-up supervising physicians form?
The back-up supervising physicians form must be filed by healthcare facilities or practitioners who are required to have a supervising physician.
How to fill out back-up supervising physicians form?
The back-up supervising physicians form should be filled out with the required information about the primary and secondary supervising physicians, as well as the contact details of the healthcare facility or practitioner.
What is the purpose of back-up supervising physicians form?
The purpose of the back-up supervising physicians form is to ensure continuity of medical supervision in case the primary supervising physician is unable to fulfill their duties.
What information must be reported on back-up supervising physicians form?
The back-up supervising physicians form must include the names, contact information, and qualifications of both the primary and back-up supervising physicians.
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