NP Collaboration / Autonomous Form
  • NP Collaboration / Autonomous Form

    NP Collaboration / Autonomous Form

  • Grow Therapy requires all Nurse Practitioners to maintain an active Collaborating Agreement with a physician for each state they practice, unless state regulations permit Full Practice Authority.

  • If you have questions about state Collaborating Physician requirements, how to obtain autonomy, or to see if you qualify for independent practice, see our Guide for Collaborative Agreement Requirements at Grow.


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  • Please select from the following:*
  • In which state(s) do you have an active license and would like to work with Grow?*

  • Please note that we cannot accept autonomous licensure for Nurse Practitioners providers in the state of FL. In order to be credentialed to work with Grow Therapy, all Nurse Practitioners in FL must hold a standard APRN License with PMHNP scope and provide an active Collaborative Agreement.

  • Date
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  • Alabama

    Collaborative Agreement is Required

  • Arkansas

  • Have you met the requirements to practice without collaboration in Arkansas?*

  • California

    Collaborative Agreement is Required

  • Colorado

  • Have you met the requirements to practice without collaboration in Colorado?*

  • Connecticut

  • Have you met the requirements to practice without collaboration in Connecticut?*

  • Florida

    Collaborative Agreement is Required

  • Georgia

    Collaborative Agreement is Required

  • Illinois

  • Have you met the requirements to practice without collaboration in Illinois?*

  • Indiana

    Collaborative Agreement is Required

  • Kentucky

  • Have you met the requirements to practice without collaboration in Kentucky?*

  • Louisiana

    Collaborative Agreement is Required

  • Maine

  • Have you met the requirements to practice without collaboration in Maine?*

  • Massachusetts

  • Have you met the requirements to practice without collaboration in Massachusetts?*

  • Michigan

    Collaborative Agreement is Required

  • Minnesota

  • Have you met the requirements to practice without collaboration in Minnesota?*

  • Mississippi

    Collaborative Agreement is Required

  • Missouri

    Collaborative Agreement is Required

  • Nebraska

  • Have you met the requirements to practice without collaboration in Nebraska?*

  • Nevada

  • Have you met the requirements to practice without collaboration in Nevada?*

  • New Jersey

    Collaborative Agreement is Required

  • New York

  • Have you met the requirements to practice without collaboration in New York?*

  • North Carolina

    Collaborative Agreement is Required

  • Ohio

    Collaborative Agreement is Required

  • Oklahoma

    Collaborative Agreement is Required
  • Have you met the requirements to practice without collaboration in Oklahoma?*

  • Pennsylvania

    Collaborative Agreement is Required

  • South Carolina

    Collaborative Agreement is Required

  • South Dakota

    Collaborative Agreement is Required
  • Have you met the requirements to practice without collaboration in South Dakota?*

  • Tennessee

    Collaborative Agreement is Required

  • Texas

    Collaborative Agreement is Required

  • Vermont

    Collaborative Agreement is Required
  • Have you met the requirements to practice without collaboration in Vermont?*

  • Virginia

    Collaborative Agreement is Required
  • Have you met the requirements to practice without collaboration in Virginia?*

  • West Virginia

    Collaborative Agreement is Required
  • Have you met the requirements to practice without collaboration in West Virginia?*

  • Wisconsin

    Collaborative Agreement is Required

  • Thanks for letting us know that you're still in the process of obtaining your Collaborating Physician Agreement.

    Please submit this form and we will email you a link to provide us with your Collaborative Agreement at a later time!

     

    Your information will not be sent to Grow until you click "Submit" below!

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