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Instructions for Change or Addition of Collaborative Physician

Change and Addition of Collaborating Physician Application

Documents Required

The Physician Assistant  must complete, date and sign the application and return it to the Professional Licensing Agency along with the items listed below:
Application Fee - The fee for the change and addition application is $50.00.  Please make all checks payable to the Professional Licensing Agency.  

Collaborative Agreement - Click here for additional information on collaborative agreements.