Indiana Nurse Practitioner Collaborative Agreement Templates

The Indiana Professional Licensing Agency outlines a detailed process for Nurse Practitioners (NPs) to establish a collaborative practice relationship with physicians. This guide is designed to ensure NPs in Indiana can form compliant and effective collaborative practices.

For a step-by-step guide on establishing these collaborative relationships, see this guide.

To aid in the development of a Collaborative Practice Agreement (CPA), the Indiana Professional Licensing Agency provides a checklist and a filled-out template example, which can serve as valuable resources:

Indiana Checklist for Developing a CPA

‍The checklist is accessible at here.

Indiana Collaborative Practice Agreement Template

‍The template is accessible at here.

Indiana Example Collaborative Practice Agreements

There are some publicly available examples of Collaborative Practice Agreements for Indiana, providing insight into how different organizations implement these agreements:

Indiana Collaborative Practice Agreement Example

‍A Collaborative Practive Agreement example is available from Shalom Health Care Center here.

Yes, Indiana requires that a nurse practitioner must have a collaborative practice agreement with a physician licensed in Indiana. IN Code § 25-23-1-19.4 (2022)