1. (1) The physician in collaborative practice with a certified registered nurse practitioner shall have:
2. (a) Possess a current, unrestricted license to practice medicine in the State of Alabama.
3. (b) Have satisfied one of the following experience requirements:
4. 1. Have practiced medicine for at least three years.
5. 2. Have practiced medicine for at least one year and certified by one or more of the specialty boards recognized by the American Board of Medical Specialties or the American Osteopathic Association; or
6. 3. Have practiced medicine for at least one year and the collaboration’s practice site is limited solely to a general acute care hospital, a critical access hospital, or a specialized hospital licensed as such by the Alabama Department of Public Health.
7. (c) Effective January 1, 2024, have obtained continuing medical education prescribed by the Board of Medical Examiners regarding the rules and statutes governing collaborative practice in Alabama, not more than forty-eight (48) months prior to or within twelve (12) months of commencement of the collaborative practice.
8. (d) Paid all collaborative practice fees due to the Board of Medical Examiners and submitted to the Board of Medical Examiners the appropriate form.
9. (2) The State Board of Medical Examiners, in its discretion, may waive the practice requirements in 1(b).
10. (3) A physician entering into a collaborative practice arrangement with a certified registered nurse practitioner, including those who have been granted temporary approval to practice as a certified registered nurse practitioner under the provisions of Rule 540-X-8-.07, shall notify the State Board of Medical Examiners in writing of the date for commencement of the collaborative practice agreement using the “Commencement of Collaborative Practice” form. The Collaborative Practice Fee must accompany the “Commencement of Collaborative Practice” form.
11. (4) A physician in a collaborative practice which is voluntarily terminated by either party is responsible for notifying the Board of Medical Examiners of the date on which the collaborative practice agreement terminates. Notification to the Board of Medical Examiners by the Alabama Board of Nursing that a Certified Registered Nurse Practitioner has voluntarily terminated a collaborative practice agreement will meet the notification requirement and will result in termination of the physician’s approval to practice under the collaborative practice agreement.
12. (5) The Board of Medical Examiners may decline to consider an application where the physician is under investigation for a potential violation of the Code of Alabama, Sections 20-2-54, 34-21-25, or 34-24-360, or any rule of the Alabama Board of Medical Examiners or Medical Licensure Commission of Alabama.
13. (6) Effective January 1, 2024, all collaborating physicians shall obtain continuing medical education prescribed by the Board of Medical Examiners regarding the rules and statutes governing collaborative practice in Alabama every forty-eight months (48) following commencement of the collaborative practice.

Author: Alabama Board of Nursing

Statutory Authority: Code of Ala. 1975, §34-21-83.

Editor’s Note: Rule .03 was renumbered to .04 as per certification filed July 2, 2015; effective August 6, 2015.

History: New Rule: Filed August 25, 2003; effective September 29, 2003. Amended: Filed July 22, 2005; effective August 26, 2005. Amended: Filed July 2, 2015; effective August 6, 2015. Amended: Filed September 27, 2018; effective November 11, 2018. Amended: Published April 30, 2021; effective June 14, 2021. Amended: Published November 26, 2025; effective January 10, 2026.