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Delegation Agreements
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On January 15, 2011, the ASAPA Board of Directors voted in favor of developing sample delegation agreements/statements to aid PA’s, Supervising Physicians, and Practice Administrators in Arizona to reach compliance with the Modernized PA practice laws outlined in HB2012 (effective January 1, 2011).

After much work and market research by our Legal and Legislative Affairs Committee, the Board of Directors approved the release of 3 sample delegation agreements along with a simplified checklist. Thank you to everyone involved in the development of these resources.

*What is a Physician Assistant Delegation Agreement?
It is an agreement that constitutes a working relationship between a physician assistant and a supervising physician. Note: A supervising physician assumes legal liability for the services provided by the physician assistant under their supervision.

*Delegation Agreement Checklist
1. A Delegation Agreement shall be signed by the PA and each Supervising Physician, filed in the practice’s office, and be available for inspection by the Arizona Regulatory Board of Physician Assistants. The delegation agreement must include:

  1. A statement that the physician will exercise supervision over the PA and retain professional and legal responsibility for the care rendered by the PA;
  2. Signatures of the Supervising Physician and the PA;
  3. An annual update;

2. Each PA must have a Prescribing Authority Form on file with the ARBoPA in order to prescribe. This is separate from the delegation agreement filed in the practice’s office. There will be no fee for filing this form. A PA can check his/her the profile at www.azpa.gov to verify that prescribing authority is on file before prescribing. (See A.R.S. 32-2532)

3. The physician may only engage in supervising four PA’s at one time, regardless of where they are geographically located. A physician can enter into a delegation agreement with >4 PA’s but only supervise four at one time.


*Sample Arizona Physician Assistant Delegation Agreements 

DISCLAIMER: The SAMPLES are TEMPLATES ONLY. This checklist or the attached SAMPLES should not be construed as legal advice. It may be important to consult your attorney.  


Additional Resources

Link to Frequently Asked Questions regarding the Physician Assistant Statute Changes
http://www.azpa.gov/PA%20Center/PANoticeCombined.pdf

Link to the Prescribing Authority Form
http://www.azpa.gov/PDFs/NOSApplication2009M.pdf

Link to A.R.S. 32-2501 Definitions
http://www.azleg.gov/FormatDocument.asp?inDoc=/ars/32/02501.htm&Title=32&DocType=ARS

A.R.S. 32-2531 PA Scope of Practice; health care tasks
http://www.azleg.gov/FormatDocument.asp?inDoc=/ars/32/02531.htm&Title=32&DocType=ARS

A.R.S. 32-2533 Supervising Physician responsibilities
http://www.azleg.gov/FormatDocument.asp?inDoc=/ars/32/02533.htm&Title=32&DocType=ARS

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