Change/Addition Anesthesiologist Assistant

INSTRUCTIONS

Change/Addition of Supervising Physician Application

If there is a change in employment or physician group practice, the anesthesiologist assistant needs to complete and submit the Change/Addition of Supervising Physician Application, and a new practice protocol.  Additional instructions concerning practice protocols can be found here.

If additional supervisors are added at a current place of employment or physician group practice, and the practice protocol for the anesthesiologist assistant at that place of employment has been approved, the names of the additional supervisors can be added as an addendum to the practice protocol.  The anesthesiologist assistant will need to complete the Change/Addition of Supervising Physician Application, but does not need to submit a new practice protocol. 

Anesthesiologist assistants adding or changing supervisors may continue practicing while this application is being processed.