Downloadable Forms
Download and edit (if desired) this agreement between APRN and physician for prescribing non-scheduled drugs.
Collaborative Prescribing Agreement (CAPA-NS)

Download and edit (if desired) this agreement between APRN and physician for prescribing scheduled drugs.
Collaborative Prescribing Agreement for Scheduled Drugs (CAPA-CS)

Use this form to let the Kentucky Board of Nursing you have a DEA registration and CAPA-CS (updated July 6 2012)
APRN Notification Form re: CAPA-CS/DEA
 
Use this form to notify the Kentucky Board of Nursing that you have rescinded a CAPA-CS


Site Search
Featured Members
Emily Anne Bailey APRN FNP-CReceived Central District Medical Services Award from the Ky Association of Health Care Facilities

KCNPNM   1017 Ash Street   Louisville, KY 40217
502.333.0076  or click Contact Us