PA Supervision Agreement FAQs

Ohio’s physician assistant laws can be found in Ohio Revised Code Chapter 4730, available here:

Q1: What is a supervision agreement?
According to ORC Section 4730.19, the supervision agreement specifies that the physician agrees to supervise the physician assistant and the physician assistant agrees to practice under that physician's supervision. The agreement should clearly state that the supervising physician is legally responsible and assumes legal liability for the services provided by the physician assistant. It should also state the responsibilities of the supervising physician and those of the physician assistant, any limitations on the responsibilities to be fulfilled by the physician assistant, and the circumstances under which the physician assistant is required to refer a patient to the supervising physician. Both the supervising physician and physician assistant must sign the agreement.

  • If the physician is the supervising physician for more than one physician assistant, the agreement may contain the signatures of the physician and all of the physician assistants being supervised.

Q2: Can a physician assistant report to more than one supervising physician?
Yes, but a physician assistant should have separate supervision agreements with each supervising physician to whom they report.

Q3: What if the supervising physician is absent or unable to supervise the physician assistant for a period?
For physician assistants practicing outside a health care facility, the supervising physician may choose to designate physicians to act as alternate supervising physicians in the event they will be absent from their role. The names, business addresses, business telephone numbers, and signature of the physicians who have agreed to be alternate supervising physicians must be listed in the agreement.


Q4: Do supervision agreements need to be filed and approved by the State Medical Board?
No. Effective September 30, 2018, Physician Assistant Supervision Agreements are no longer filed or approved by the board due to changes in Ohio law (HB111 of the 132nd General Assembly).

Q5: Is there a required format for the supervision agreement?
No. There is no required format for the agreement. However, for your convenience, the board has created two forms that may be used as templates. They are located on the Medical Board’s website:

Q6: Can a supervision agreement be updated or changed?
Yes. They are living documents that remain active and can be amended at any time until terminated. An addendum can also be used to make updates to the agreement. In the event the original agreement cannot be located, a new agreement should be created. It is especially important that the agreement be updated to reflect the change in the event a physician assistant is no longer being supervised by the physician.

Q7: Does a supervision agreement expire or need to be renewed?
No. Now that the board no longer approves the agreement, the agreement has no expiration or renewal date.

Q8: Where should the agreement be stored?
The supervising physician is responsible for keeping the agreement in their records. The agreement must be readily accessible to the supervising physician and physician assistant as a reference document and to the Medical Board in the event of an on-site inspection. It can be an electronic document or a printed document.

Q9: How do I terminate my supervision agreement?
There are not specific requirements for how changes to the information contained in a supervision agreement should be made. Removal of a physician assistant could be denoted by attaching an addendum with the signature of the supervising physician and physician assistant and stating the name of the physician assistant and the last date on which the physician assistant practiced under the agreement. Since there is no longer a supervision agreement form that gets submitted to the Medical Board, you do not need to notify the Medical Board to terminate a supervision agreement. However, it is important that a supervision agreement accurately reflect the names of all physician assistants who practice under the supervision of the physician.