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(1/2022)STATE BOARD OF MEDICINE Email: stmedicine@pa.govPhone 7177831400/7177872381NURSEMIDWIFE COLLABORATIVE AGREEMENT CHANGE FORM The nurse midwife shall notify the Board, in writing, of a change
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How to fill out nurse-midwife collaborative agreement change
How to fill out nurse-midwife collaborative agreement change
01
Review the requirements for the nurse-midwife collaborative agreement change
02
Obtain the necessary paperwork and forms for the change
03
Fill out the forms accurately and completely
04
Submit the completed paperwork to the appropriate authority for approval
05
Follow up to ensure the change has been processed successfully
Who needs nurse-midwife collaborative agreement change?
01
Nurse-midwives who have undergone changes in their collaborative agreement terms or arrangements
02
Healthcare facilities or institutions where the nurse-midwife practices that require updated collaborative agreements
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What is nurse-midwife collaborative agreement change?
Nurse-midwife collaborative agreement change refers to any modifications made to the agreement between a nurse-midwife and a collaborating physician that outlines the scope of practice and supervision requirements.
Who is required to file nurse-midwife collaborative agreement change?
The nurse-midwife and the collaborating physician are required to jointly file the nurse-midwife collaborative agreement change.
How to fill out nurse-midwife collaborative agreement change?
To fill out the nurse-midwife collaborative agreement change, both the nurse-midwife and collaborating physician must review the existing agreement, make the necessary changes, and sign and submit the updated agreement to the relevant authorities.
What is the purpose of nurse-midwife collaborative agreement change?
The purpose of nurse-midwife collaborative agreement change is to ensure that the agreement accurately reflects the current scope of practice, supervision requirements, and responsibilities of the nurse-midwife and collaborating physician.
What information must be reported on nurse-midwife collaborative agreement change?
The nurse-midwife collaborative agreement change must include the updated scope of practice, supervision requirements, contact information of the nurse-midwife and collaborating physician, and the effective date of the changes.
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