APRN Protocol Registration Forms - Related Files
APRN Protocol Registration Forms
Please find below the complete application and additional forms needed to submit an APRN Protocol Agreement registration. All Protocols that have been received and reviewed by the Board can be found here.
HOW
TO GET YOUR FILE REVIEWED THE FIRST TIME
APRN
Protocol Agreement
(use this form to expedite the protocol review)
FORM
A - Designated Physician Information
FORM
B - Protocol Agreement Termination
FORM
C - Protocol Agreement Worksheet rev 10/2019
For questions about your APRN Protocol agreement, please contact the correct specialist
APRN Licensing Specialist, Last name A-K Kierra Battle
APRN Licensing Specialist, Last name L-Z Akia Coley