Online Written Agreement

Important Announcement regarding Written Agreements

The BPOA Commissioner Kalonji Johnson announced the written agreement applications are now available online for the State Board of Medicine and State Board of Osteopathic on the PALS website https://www.pals.pa.gov/#/page/default

Steps to find the written agreement application on your dashboard:

  1. Log into your PALS account
  2. Scroll down to Professional License Details section, click on the green pencil icon next to your license number.
  3. On the Change Options pop-up, select Written Agreement

Paper written agreements will only be accepted until April 30, 2021.

On the main Medical and Osteopathic Medicine website, instructional packets and videos have been posted. The applications can either be started by the PA or the primary supervising physician. Here are the steps to find the instructions for each board:

MEDICAL BOARD IF YOUR PRIMARY IS A MD

  1. Log into https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Pages/default.aspx
  2. Go to grey box on right and click General Board Information (including applications and forms)
  3. Under Board forms and resources, click initial applications
  4. Scroll down, click link to Physician Assistant Supervising Physician link
  5. The following options will be shown

OSTEOPATHIC BOARD IF YOUR PRIMARY IS A DO

  1. Log into https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/OsteopathicMedicine/Pages/default.aspx
  2. Go to grey box on right and click General Board Information (including applications and forms)
  3. Under Board forms and resources, click initial applications
  4. Scroll down, click link to Physician Assistant Supervising Physician link
  5. The following options will be shown

Overall instructions as posted on the Board website:

If you have submitted a paper application and fee to the Board, do not submit the application electronically. This will create a discrepancy and the application fees are non-refundable.

The written agreement application involves a workflow between the supervising physician and physician assistant. When it is time for each party to complete their portion of the application, emails will be sent to the email address on the licensee’s PALS profile. Applications will not be submitted until the final step of making payment. The individual that submits the application will be able to view the application status and respond to discrepancies online. Discrepancies and approvals will be emailed to both the supervising physician and physician assistant. Responses to discrepancies must be uploaded to the application.

Items you will need prior to starting the application: Valid license numbers of the physician assistant, primary supervisor, and substitute supervisor. The primary supervising physician and physician assistant must be under the same Board (Example: Primary supervisor license number starts with MD; physician assistant license number starts with MA). You will need to enter the details describing the functions/tasks to be delegated to the physician assistant, details describing the time, place, and manner of supervision, practice location information, chart review deviation (if applicable), and drug prescribing/dispensing information. This information can be cut and pasted into the fields from templates. The physician assistant will need to upload proof of insurance. Applications can only be submitted with a valid credit card payment. The application initiator will be required to submit the payment.

DIRECT LINKS FOR INSTRUCTIONS

State Board of Medicine written instructions for written agreement initiated by a PA
https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Documents/Board%20Documents/MedM%20-%20Online%20Written%20Agreement%20User%20Guide%20-%20initiated%20by%20Physician%20Assistant.pdf

State Board of Medicine written instructions for written agreement initiated by a Primary supervising physician
https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Documents/Board%20Documents/MedM%20-%20Online%20Written%20Agreement%20User%20Guide%20-%20initiated%20by%20Physician%20and%20Surgeon.pdf

State Board of Osteopathic Medicine written instructions for written agreement initiated by a PA
https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Documents/Board%20Documents/MedM%20-%20Online%20Written%20Agreement%20User%20Guide%20-%20initiated%20by%20Physician%20Assistant.pdf

State Board of Osteopathic Medicine instructions for written agreement initiated by a Primary supervising physician
https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Documents/Board%20Documents/MedM%20-%20Online%20Written%20Agreement%20User%20Guide%20-%20initiated%20by%20Physician%20and%20Surgeon.pdf

 

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