Transcription of PHYSICIAN ASSISTANT'S RESPONSIBLE PHYSICIAN …
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PHYSICIAN ASSISTANT'S RESPONSIBLE PHYSICIAN …
PHYSICIAN ASSISTANT'S RESPONSIBLE PHYSICIANand DRUG PRESCRIPTION PROTOCOL Please enter required information, including signatures and dates on page 2 and page or fax ASSISTANT'S Name:License Number: RESPONSIBLE PHYSICIAN 's Name::License of the PHYSICIAN 's practice and way in which the physicianassistant is to be utilized (please include the routine duties of the physicianassistant, the type of practice, and the practice setting) locations, including hospitals, at which the PHYSICIAN assistant willroutinely perform acts constituting the practice of medicine and understand the RESPONSIBLE PHYSICIAN will always be available forcommunication with the PHYSICIAN assistant within 30 minutes during theperformance of patient service by the PHYSICIAN understand that failure to adequately direct and supervise the physicianassistant in accordance with PHYSICIAN assistant Licensure Act, or rulesa
PHYSICIAN ASSISTANT'S RESPONSIBLE PHYSICIAN and DRUG PRESCRIPTION PROTOCOL Please enter required information, including signatures and dates on page 2 and page 4.
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