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Name:___ DOB: ___Nurse Practitioner & Physician Assistant Consent Here at FOUNDATION PAIN AND SPINE, we strive to offer you high quality medical care and give strong consideration to your wait time.
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Gather necessary personal information such as name, address, contact details, and insurance information.
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Who needs nurse practitioners as primary?

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Patients who need primary care services
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Nurse practitioners as primary care providers are advanced practice registered nurses who are trained to assess, diagnose, and treat patients in a primary care setting.
Nurse practitioners as primary can be filed by healthcare facilities, clinics, and medical practices that employ nurse practitioners as primary care providers.
To fill out nurse practitioners as primary, include information about the nurse practitioner's qualifications, scope of practice, and patient care responsibilities.
The purpose of nurse practitioners as primary is to provide quality primary care services to patients who may not have access to a physician.
Information that must be reported on nurse practitioners as primary includes the nurse practitioner's name, certification, and any supervising physician.
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