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Physician Assistant Practice Agreement Online Portal

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Please Note: On every page of this form you have the option to "Save and Resume Later" (see link above). Each time to use the Save and Resume Later link you get a special URL that will bring you back to the form without losing data. Because this is a long form, we suggest you use the Save and Resume Later link occasionally so you don't lose data before you submit the form.

The Practice Agreement Online Portal should be used to file a practice agreement with the WMC. Once the practice agreement has been submitted, the email address provided in the PA Section of the agreement will receive an official PDF copy of the practice agreement. It will be that person’s responsibility to forward the copy to all necessary parties to keep on file. The Medical Commission will also receive a copy of the practice agreement upon submission and will update our system accordingly. If the Medical Commission has any questions about the practice agreement or the information provided, we will contact the PA by email.

The online practice agreement portal is in place of the previous stamped delegation agreement. We will no longer be sending out copies of the agreement with an approved stamp and a signature. With this new process, each agreement will have a submission date and time, which is located on the top left corner of the first page. Once the practice agreement is submitted and the appropriate party receives the confirmation email, the PA can begin working immediately.

More Information, Amendments to a Practice Agreement and Termination of a Practice Agreement forms can be found here