Online Written Agreement Information - Pennsylvania Society of Physician Associates

Update on the implementation of changes within PALS due to Act 78/79

Paper written agreement change forms will only be accepted until January 31, 2022. Click here for details

Steps to Find Online Written Agreements

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:

Log into your PALS account
Scroll down to Professional License Details section, click on the green pencil icon next to your license number.
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

Log into https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Pages/default.aspx
Go to grey box on right and click General Board Information (including applications and forms)
Under Board forms and resources, click initial applications
Scroll down, click link to PA Supervising Physician link
A list of documents will be shown

OSTEOPATHIC BOARD IF YOUR PRIMARY IS A DO

Log into https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/OsteopathicMedicine/Pages/default.aspx
Go to grey box on right and click General Board Information (including applications and forms)
Under Board forms and resources, click initial applications
Scroll down, click link to PA Supervising Physician link
A list of documents will be shown.

Overall instructions as posted on the Board website:

The written agreement application involves a workflow between the supervising physician and PA. 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 PA. Responses to discrepancies must be uploaded to the application.

Items you will need prior to starting the application: Valid license numbers of the PA, primary supervisor, and substitute supervisor. The primary supervising physician and PA must be under the same Board (Example: Primary supervisor license number starts with MD; PA license number starts with MA). You will need to enter the details describing the functions/tasks to be delegated to the PA, 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 PA 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.