Georgia nurse protocol agreements: filing, contents and the procedure log.
An act performed under an unfiled or lapsed agreement has no delegation standing behind it, whatever the signed contract in the drawer says.
The short answer
Thirty days to file. Rule 360-32-.03 requires the agreement to be received by the Board within 30 days of execution; amendments carry the same deadline. A protocol left incomplete on file for more than three months is deemed invalid.
For procedures not mastered in the APRN's own training — which in an aesthetic practice means most of them — the Board also requires a procedure log: at least 10 under direct physician supervision and 10 independent, one form per procedure.
What the agreement must contain
Rule 360-32-.02: names, addresses, and license numbers; practice locations; the drugs, devices, and treatments authorized; a provision for immediate consultation; the applicable standard of care; conditions requiring physician evaluation; documentation requirements; prescription form specifications; and the schedule for periodic patient record review. A generic template that omits any of these is not compliant simply because it is signed.
The procedure log
The Board's APRN Procedure Log is required before an APRN performs a procedure that was not specifically mastered during their education and training: at least 10 procedures under the direct supervision of the delegating physician and at least 10 performed independently, signed by both and submitted to the Board. A separate form is filed for each procedure. Injectables and energy-based treatments are not part of a standard APRN curriculum.
Specialty mismatch cannot be cured
Rule 360-32-.04(3) bars a protocol between a physician and an APRN whose specialty areas are not comparable. The Board's APRN guidance lists specialty mismatch among deficiencies that cannot be cured — the protocol is not returned for correction; it does not stand. See who can be a med spa medical director.
Ongoing obligations after filing
Rule 360-32-.05 requires the physician to document direct on-site observation of the APRN's practice at least once a year and to review medical records quarterly. The obligation is to keep the record: oversight that happened and was never documented looks identical, on inspection, to oversight that never happened.
How Local Medical Directors helps
Our NP and PA collaboration support covers the protocol itself, the procedure logs, and the documented annual observation and quarterly chart review — the records an inspector actually asks to see.
How long does a Georgia nurse protocol agreement take to file?
Rule 360-32-.03 requires that the agreement be received by the Board within 30 days of the date it is executed, and the same 30-day deadline applies to amendments. A protocol that remains incomplete on file for more than three months is deemed invalid.
What proof should a med spa keep that its protocol was filed?
Proof of acceptance by the Board, not just proof of mailing. An agreement that was sent but never accepted leaves every act performed under it without delegation behind it.
Does a Georgia physician have to be on site to supervise an APRN?
Not during each procedure. Rule 360-32-.05 requires documented direct on-site observation of the APRN at least once annually and quarterly medical record review, along with a protocol provision for immediate consultation.