Illinois Nurse Practitioner Collaborative Agreement Templates

Research & Editorial Team
Illinois Nurse Practitioner Collaborative Agreement Templates

In Illinois, Nurse Practitioners (NPs) may need to develop a collaborative practice agreement, termed a Written Collaborative Agreement (WCA), to formalize the collaborative relationship with a physician. The Illinois State Medical Society provides guidance on this process.

Details on developing a Written Collaborative Agreement (WCA), including a template, can be found in a document available here. The document contains a section titled "SAMPLE WRITTEN COLLABORATIVE AGREEMENT" which serves as a template for these agreements.

Additionally, for NPs intending to prescribe controlled substances, the state of Illinois mandates a specific process for a collaborating physician to delegate prescriptive authority. Guidance on this process is available here.

As part of this delegation, the collaborating physician must complete and submit a form, which can be accessed here.

The CPA documentation set in Arkansas includes two primary documents, for which the state has provided templates:

Illinois Written Collaborative Agreement Template

The template is accessible at here.

Illinois Notice of Delegated PrescriptiveAuthority for Controlled Substances (APRN-CS)

The template can be found here.

Is a collaborative practice agreement required in Illinois?

Yes, Illinois requires that a nurse practitioner with less than 4,000 hours of clinical experience must have a collaborative practice agreement with a physician licensed in Illinois. (225 ILCS 65/) Nurse Practice Act

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