APRN Protocol Registration Forms

📌 Important Notes

• Electronic Submission: 

  • Complete all forms online and submit via NextRequest → gcmb.nextrequest.com

• DEA Prerequisite: 

  • You must have an active APRN Protocol Agreement on file before applying for your Georgia DEA.

• Fee Payment ($150):

  • Pay by check or money order (payable to “GCMB”).
  • Scan or photograph your payment and upload it with your forms.
  • Mail the physical payment & a copy of your Registration Page to:

2 Martin Luther King Jr. Drive SE East Tower, 11th Floor
Atlanta, GA 30334 US

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📋Submission Requirements

• Complete & Sign your APRN Protocol Agreement (use Board template on Page 2 of the Registration Form).
• Include Payment Proof in your portal upload.
• Mail Payment as described above.
• Maintain a Copy: Please note, per O.C.G.A. § 43-34-25, the APRN and Physician are responsible for maintaining a copy of the protocol and must be able to produce it upon request from the Medical Board or the Nursing Board

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📄 Additional Protocol Information

• Reviewed Protocol Agreements (updated after each Board meeting) → Nurse Protocol Agreements Reviewed by the Board
• Outstanding Documents? Send via NextRequest (include APRN’s full name in the subject).

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📍 Important Information about the Delegating Physician's Location

A delegating physician in Georgia must have an active state license and practice within the state or within 50 miles of where the patient is located when receiving services. This applies to both in-person and telehealth services provided by an APRN and is independent of the business model.

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✅ APRN Protocol Review Simplified:

Most APRN protocols are approved without the need for review by the APRN Committee or the full Board, known as administrative approval. However, protocols may require further review if they present “red flags,” such as:

• Disciplinary actions on the APRN’s or physician’s license.
• A mismatch in specialties between the APRN and the delegating physician.
• Use of a non-standard protocol agreement by the APRN.
• Procedures listed in Form-C that are outside the APRN’s specialty.

If a protocol meets all statutory requirements and is free of red flags, it will be administratively approved, and an approval letter will be issued. This letter is crucial for subsequent credentialing steps, like DEA registration and hospital privileges. APRNs are advised to wait for this approval before applying for DEA privileges.

The processing time for protocol approval varies, ranging from a few weeks to months, depending on the application’s completeness. To expedite approval, it’s best to submit correct and complete documentation initially. Quick responses to Board staff communications can also reduce processing times.

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