Utah Code § 58-81-103

Eligibility for volunteer health care practitioner license -- Delegation of service agreement
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58-81-103. 
Eligibility for volunteer health care practitioner license -- Delegation of service agreement.
 
 
 
 (1) A health care practitioner is eligible to apply to the division and board for a volunteer health care practitioner license if the health care practitioner: 
 
 (a) certifies to the division and board that the applicant will be engaged exclusively in volunteer health care services; and 
 
 
 
 (b) completes an application for a volunteer health care practitioner license, which includes documentation: 
 
 (i) of professional education, exams passed, and graduation; 
 
 
 
 (ii) of practice history; 
 
 
 
 (iii) of a qualified location for which the health care practitioner will be practicing; 
 
 
 
 (iv) identifying the supervising health care practitioner and the supervising health care practitioner's delegation of service agreement with the volunteer practitioner; and 
 
 
 
 (v) that the applicant has: 
 
 (A) previously been issued an unrestricted license to practice in Utah, another state of the United States, or a district or territory of the United States; 
 
 
 
 (B) never been the subject of any significant disciplinary action in any jurisdiction; and 
 
 
 
 (C) is in good health and does not have a condition which would impair the health care practitioner's ability to practice with reasonable skill and safety to patients. 
 
 
 
 
 
 
 
 
 
 (2) A health care provider who has agreed to be a supervising professional for a volunteer at a qualified location shall: 
 
 (a) enter into a delegation of service agreement with the volunteer health care practitioner; 
 
 
 
 (b) agree to provide the level of supervision required in Subsection 58-81-102(6); 
 
 
 
 (c) determine with the volunteer whether the volunteer's scope of practice or ability to prescribe controlled substances will be limited by the delegation of service agreement; 
 
 
 
 (d) include in the delegation of service agreement that the volunteer may not prescribe a controlled substance to himself, the volunteer's family, or a staff member of the qualified location; and 
 
 
 
 (e) forward the delegation of service agreement to the division.

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