N.M. Admin. Code § 16.22.25.8 - APPLICATION FOR PRESCRIPTION CERTIFICATE
A. An applicant for a prescription
certificate shall submit a complete application on a form approved by the
board. The applicant is responsible to ensure that the application is complete
and timely and that all application fees are paid.
B. The application procedure, shall commence
no sooner than 60 days and no later than 10 days prior to expiration of the
conditional prescription certificate, whereby the applicant shall submit a
non-refundable fee (see fee schedule at 16.22.13.8 of these regulations)
established by the board and shall submit evidence satisfactory to the board
that the applicant:
(1) has been issued a
conditional prescription certificate and has successfully completed or
anticipates successfully completing two years of prescribing psychotropic
medication, as certified by the primary supervising clinician pursuant to
16.22.24 NMAC of these regulations;
(2) holds an active and unrestricted license
to practice psychology in New Mexico;
C. The
application shall also include the following:
(1) a log of patients seen, which shall
include: a coded identification number for the patient, patient's age, gender,
diagnosis, whether or not pharmacological intervention was considered or
implemented, date of service, and amount of time seen for psychopharmacotherapy
or management of care. The log shall contain the name and signature of the
supervising clinician;
(2) a log of
supervision, which shall include date of supervision, time spent in
supervision, topics covered, and the name of the primary or secondary
supervising clinician who provided supervision. The log shall be signed by the
primary supervising clinician.
D. Only a complete application will be
considered. The board may request additional information from the applicant to
verify or confirm the information in the application.
Notes
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