Nurse Practitioner Initiatives

The CRNA appreciates that there is excitement regarding the new opportunities for NPs and recognizes that they are highly sought professionals in Alberta. The College remains committed to ensuring equitable registration opportunities and improving our processes for the benefit of Alberta’s health acre ecosystem.

The College appreciates the skills and expertise that nurse practitioners (NP) bring to Alberta's health care ecosystem.

Here you will find information about programs related to NPs, and details about how the College is supporting them through these initiatives.

Nurse Practitioner Primary Care Program (NPPCP)

Announced by the Government of Alberta in April 2024, the NPPCP is an exciting initiative for NPs who wish to practise comprehensive primary care and operate their own independent clinics, or practise independently in team-based care settings.

Frequently Asked Questions

Practising as an NP in Alberta

Where can I find more information about self-employed practice in Alberta?

Registrants of the CRNA can find more information about self-employed practice here.

For further guidance, you can reach out to our practice consultants.

Can all NPs provide patient care in the primary care setting? Do I need to have specialization in a specific stream of practice?

NPs receive their entry to practice education within differing streams of practice with a focus on a specific demographic (adult, family all ages (FAA), neonatal and child).

NPs must have the knowledge, skills, training, competency and currency to provide patient care in the primary care setting as an MRP.

Typical health care services delivered in primary care settings include, but are not limited to:

Providing first contact accessibility, ongoing care and continuity for comprehensive health care needs
Managing chronic health conditions
Diagnosing new health conditions
Ordering diagnostic testing and developing treatment plans
Health promotion
Assessment and testing through programs such as Screening for Life
Referrals to specialists when indicated

NPs are encouraged to self-assess their knowledge, skills, training, competency and currency to determine if they are able to provide effective and safe care in a primary care setting as the MRP.

Do I need to continue to follow the CRNA's standards of practice?

Registrants of the CRNA are required to follow the standards of practice at all times, regardless of their practice setting. Additionally, the CRNA's guidelines and scope of practice documents can provide further guidance. If you have questions about a specific standard of practice, reach out to our practice consultants.

What CPSA standards should an NP be familiar with?

The CPSA Standards of Practice documents for NPs to be familiar with include:

Do the College of Physicians and Surgeons of Alberta's (CPSA) Standards of Practice for medical clinics apply to me as an NP?

Patients and their families require health care services provided in a safe, competent and responsible manner that aligns with regulatory expectations (including the provider practising within their scope of practice).

Within the NPPCP, patients can expect their health care needs to be provided in a similar manner to other providers (i.e. professional services, privacy, continuity of care).

The CRNA is currently developing formal regulatory guidance that addresses the unique role of NPs in the health care system. In the meantime, the FAQs outlined on this page will provide direction to registrants regarding the CRNA’s general expectations.

NPs are regulated by the CRNA, not by the CPSA; however, to ensure patient safety, the CRNA encourages NPs to familiarize themselves with the expectations physicians are held accountable to by the CPSA. The CPSA’s regulatory guidance for physicians can be viewed as expectations NPs are also held accountable to.

If there are questions related to the CPSA’s standards in relation to NP practice, please contact the CRNA, NOT the CPSA.

The CRNA would like to acknowledge the CPSA’s expertise and leadership with the development of their standards of practice which outline very clearly, expectations for the delivery of patient care in an independent practice setting. The CRNA is very appreciative that the CPSA is supportive of referring NPs to their standards of practice.

Should new-to-practice NPs or those changing their practice area seek mentorship from experienced NPs or physicians?

New-to-practice NPs are encouraged to seek mentorship from experienced, competent NPs or physicians during the first 18 months of practice, or when transitioning from one practice area to another (e.g., moving from acute care to primary care). Mentorship serves to bridge the gap between education and professional practice (or changing practice areas), enabling NPs to fully understand their scope of practice while developing the necessary knowledge, confidence and competence.

Mentorship can involve coaching, teaching, advising and support. To be most impactful, the mentor should have the expertise in the skillset the mentee wants to develop. A clinical mentor helps:

Answer clinical questions
Develop new skills
Identify opportunities for improvement
Share learning opportunities

Non-clinical mentorship is also encouraged. Non-clinical mentorship may cover topics such as business considerations, contract negotiations, workplace challenges and self-care.

The NPPCP provides NP mentorship support. More information can be found in the Nurse Practitioner Primary Care Program guide, page 5.

What expectation does CRNA have regarding NPs providing uninsured services?

NPs must be aware of potential conflicts of interest when providing uninsured services (e.g., uninsured aesthetic treatments), alongside publicly funded health services. The CRNA expects NPs to act in the patient’s best interests and not be affected or influenced by other competing interests such as financial, non-financial, direct or indirect transactions. Equitable access to publicly funded health services in accordance with the CNA Code of Ethics should be prioritized.

When offering uninsured services, NPs must avoid using their position to promote uninsured services or products to patients.

Patients receiving uninsured NP services should not receive preferential access to publicly funded services. NPs participating in the NPPCP program have additional requirements (Nurse Practitioner Primary Care Program guide, page 6).

Patients receiving publicly funded health services should not feel obligated or offered incentives to access uninsured services. Patients should be able to clearly distinguish between uninsured services and publicly funded health services to avoid any perception of NP influence. The NP may want to consider business practices that include separate physical spaces, distinct operating hours and unique advertising such as signage, phone numbers and websites.

Referrals to NP uninsured services should only occur when no viable alternatives exist for the patient’s needs.

If an NP provides both uninsured and publicly funded health services, documentation of any conflict-of-interest disclosure must be made in the patient’s record.

What should NPs know about charging fees for uninsured services and selling products?

NPs can charge reasonable fees for uninsured services, ensuring they follow ethical and transparent practices. As per the Health Professions Act, NPs cannot sell medications. They may sell other products, ensuring prices do not exceed fair market value plus reasonable handling costs.

It is important to note that the CRNA does not prescribe specific fee amounts for uninsured services or products. Instead, NPs are expected to set reasonable fees that reflect professional and administrative costs while considering patients' financial circumstances.

Additional resources that you may find helpful:

About the Nurse Practitioner Primary Care Program (NPPCP)

How will the funding relationship between NPs and the Government of Alberta work?

For questions related to the funding of the NPPCP contact the NPAA or refer to the Government of Alberta website.

How can I apply to the NPPCP?

Information about the NPPCP, including the application, can be found on the Government of Alberta website. You can also contact the Nurse Practitioner Association of Alberta (NPAA) for more information.

You do not need to send your initial application for the NPPCP to the CRNA. Applications to the NPPCP can be made only through the Government of Alberta at this time.

How do the Use of Title Standards apply to NPs participating in the NPPCP?

Regulated professional staff must make the public aware of their names and professional designations. Registrants of the CRNA are required to practice using their legal names.

For non-regulated clinic staff the public should be aware of their names and job titles.

For role clarity, NPs who have also have an academic doctoral credential may include their credentials behind their name or in conversations with patients and their families.

Setting up a Primary Care Clinic

What is required to begin operations for a Nurse Practitioner clinic in Alberta?

Before opening your clinic, ensure you’re prepared to meet all applicable operational requirements, privacy and CRNA standards.

1. Complete Alberta Health business and facility registration forms:

Facility Registration Form (AHC0910A): To register a clinic and NPs providing services. The College of Physicians & Surgeons of Alberta will provide a letter for the outlined requirement “copy of the College of Physicians and Surgeons of Alberta Clinic Registration Letter” by calling CPSA Clinic Registry at 780-969-5001 or email clinicregistry@cpsa.ab.ca.
Business Arrangement and Relationships Application Form (AHC11236): To create and modify business arrangements and their associated relationships to be able to receive payment from Alberta Health.
Practitioner Identification Number/Prac ID (AHC11234): To register NPs and create business arrangements.

The forms noted above can all be found at the Government of Alberta's Health Professional Business Forms. Also, be sure to review:

Self-employed Practice: CRNA's Self-employed Practice
Privacy: CRNA's Privacy and Management of Health Information Standards and the NP Privacy FAQs (below).
Infection Prevention and Control: CRNA's Infection Prevention and Control Standards and NP Infection Prevention & Control FAQs (below).
Alberta Government Personal Services Regulation

2. Register with the Tracked Prescription Program if you will be prescribing medications prone to misuse.

3. Obtain a Workers' Compensation Board (WCB) Billing Number if you will be treating WCB patients. Additional Alberta Health resources that you may find helpful:

Does the CRNA have standards for NPs who own their own primary care clinics (community)?

The CRNA is currently developing and updating standards and guidelines for practice to outline clear expectations of registrants when providing patient care in independent practice settings.

The CPSA Standards of Practice can be reviewed for reference as outlined above.

What do I need to do as an NP to develop the required skills and competencies to provide care in my own NP primary care clinic?

For guidance on developing skills and competencies, you can reach out to our practice consultants.

Athabasca University offers an opportunity to take additional education for NPs who also wish to be dually licenced for family all ages (FAA).

What should I consider when naming my clinic?

Choose a name that clearly reflects your area of practice and services. Follow the CRNA's Advertising Standards and the Code of Ethics. Keep it factual and transparent. Your name should not mislead, imply superiority or create unrealistic expectations. You are responsible for how your clinic name is used across all platforms — oral, print and/or electronic. Signage should help people identify your clinic without solicitation. These guidelines apply to all clinic types (e.g. uninsured services and publicly funded health services) no matter the services offered.

Privacy

Do I need to prepare a privacy impact assessment (PIA) to open my own primary care NP clinic?

A PIA is required by a custodian any time there are:

New administrative practices or information systems relating to the collection, use and disclosure of individually identifying health information
Changes to existing administrative practices or information systems relating to the collection, use and disclosure of individually identifying health information Privacy and Security Polices for Custodians provides NPs with a template for the development of policies and procedures custodians can use when submitting a PIA to the Office of the Information and Privacy Commissioner of Alberta (OIPC)

Custodian as defined in the HIA (2000). A custodian includes the following:

hospital boards, nursing home operators, provincial health boards
ambulance operators, regional health authority, the Health Quality Council of Alberta, licensed pharmacies
health-care professionals that are designated under the Health Information Regulation (Alta Reg 70/2001).

What privacy requirements must be considered before opening an NP clinic?

NPs must review and understand their duties to protect patient privacy, including: the Privacy and Management of Health Information Standards and Privacy and Security Policies for Custodians.

Additional resources include:

Health Information Act (HIA) and HIA Health Information Regulation (2000)
Freedom of Information and Protection of Privacy Act (FOIP) (2000)
FOIP resources
Personal Information Protection Act (PIPA) (2003)
PIPA resources
Office of the Information and Privacy Commissioner of Alberta (OIPC) resources

Alberta Health (AH) HIA resources are available to assist with understanding the rules governing and protecting health information in the custody or under the control of a custodian:

The HIA Help Desk at 780-427-8089 (toll free 310-0000) or HIAhelpdesk@gov.ab.ca
HIA Guidelines and Practices Manual
HIA Guidelines and Practices Manual, Duty to Notify
HIA Guidelines and Practices Manual, Amendments

How should an NP maintain records in their primary care NP clinic or in a primary care network (PCN)?

Registrants should follow the Documentation Standards for patient records. Additional information can also be found in the Privacy and Management of Health Information Standards.

Infection Prevention and Control

What Infection Prevention and Control (IPC) Standards should I consider?

Maintaining a safe, clean, and compliant clinic is essential for patient care and professional practice. Here are key steps to meet IPC requirements:

1. Become familiar with general IPC standards:

2. Review reusable and single-use medical device resources:

Absence/Closing/Relocating/Leaving a Clinic

What is required of an NP who takes an absence from their clinic?

The CRNA expects NPs to arrange for coverage of their clinical practice when they are away or unavailable (e.g. vacation, after hours coverage, etc.).

For example, a call schedule could be developed for weekend or evening coverage, or longer absence arrangements could be made with a colleague to provide coverage.

What does an NP need to do when closing or leaving a primary care NP clinic?

When closing or leaving a practice, the CRNA expects NPs to consider patients they have been providing care for and endeavour to assist the patients to find another care provider.

NPs must do their best to not abandon patients, in accordance with the Canadian Nurses Association Code of Ethics for Registered Nurses.

All outstanding testing and investigations must be followed up with or arrangements must be made with another provider to do so. The patient must be well informed, preferably in writing, of what to expect and who they should be working with. NPs should also ensure all outstanding referrals have been completed.

Patients, other health professionals and health institutions need to be given adequate notice that the NP is closing or leaving the practice. Notice is required since patients must find another health care provider, so other providers need to know where to send outstanding consultations, etc.

NPs must make arrangement for the disposition of patient records, as outlined in the Privacy and Management of Health Information Standards, and the Privacy and Security Policies for Custodians.

Contact the Office of the Information and Privacy Commissioner (OIPC) of Alberta with privacy and management of patient information legislative requirement questions at generalinfo@oipc.ab.ca.

What must be considered when relocating a primary care NP clinic and expecting to maintain ongoing care?

An NP must notify the CRNA with a change to practice location in accordance with the Health Professions Act (HPA, Part 2, 4.0 (b) iii and 4.1).

The CRNA expects NPs to notify all health providers who they refer to or are referred to them, as well as professional working relations, of the location change.

Patients on an NP's panel must be given adequate notice, preferably in writing, prior to the relocation. Current patients should have the option of receiving care at the new location. If it is an option and a patient prefers to stay at the current clinic, the NP must provide access to the patient's outstanding investigations, consultation reports and any other information regarding the patient's health needs.

Oversight

Does the College of Registered Nurses of Alberta (CRNA) regulate clinics?

The CRNA is responsible for regulating NPs and RNs in Alberta. The CRNA does not regulate clinics. Instead, the CRNA is responsible for regulating NPs' practice within clinics.

If an NP is engaged in independent practice, or if the NP is the clinic director, they are accountable and responsible to ensure the clinic meets the requirements for the safe delivery of patient care (e.g. supervision, infection prevention and control measures, properly credentialed and trained staff, protection of patient health information).

Please see the clinic director questions below for more information.

Do NP clinics require a clinic director?

All NPs are accountable for the care they provide to their patients and to follow the applicable legislation, regulations and the CRNA’s Standards of Practice.

Federal and provincial legislation often refers to a “medical practitioner” as someone who can practise medicine. The terms “medical practice” and “medical director” are most commonly associated with physician practice.

Clinic director is therefore the preferred term for an NP in this role, rather than medical director.

In practice settings with multiple providers and staff, a clinic director is responsible for overseeing the non-clinical aspects of the clinic (e.g. staffing, advertising, infection prevention and control requirements, and safe handling of health records) and assisting with establishing policies and procedures for the clinic to guide safe patient care.

What are the roles and responsibilities of a clinic director?

A clinic director is accountable for the overall leadership of the clinic to ensure the safe, competent and ethical delivery of patient care. Clinic director responsibilities may include, but are not limited to:

Overall leadership of the clinic
Ensuring all staff have the appropriate qualifications to perform their roles
Quality assurance and improvement
Ensuring staff within the clinic (including regulated and non-regulated staff) are following clinic policies, processes and procedures
Ensuring the clinic aligns with legislative and regulatory requirements, the CRNA’s Standards of Practice, guidelines, advice to the profession and other regulatory documents, including but not limited to: Advertising Standards, Infection Prevention and Control Standards, Documentation Standards, Privacy and Management of Health Information Standards, Privacy and Security Policies for Custodians, Interprofessional Collaboration Guidelines, Use of Title Standards, and Use of the Title "Doctor" or "Dr."
Ensuring the public is aware of clinic members’ names and specific roles within the clinic.

What does most responsible practitioner/provider (MRP) mean?

MRP refers to a regulated health care professional (usually a medical doctor or NP) who has the overall responsibility for directing and coordinating the care and management of a patient over a specific period of time.

The designated MRP at an institution or health care site is typically identified in the site’s policies and procedures. Adapted from Canadian Medical Protective Association.

Within the NPPCP, NPs are identified as the MRP for the patients on their panel. The NP is accountable to ensure the patients health care needs are met, including completing any required referrals, ordering tests or procedures and ensuring follow-up is completed within an appropriate amount of time as dictated by the urgency of the patient’s care needs.

Is CRNA approval needed for an NP to form a corporation?

In Alberta, nurse practitioners can form corporations to offer professional services without the CRNA’s approval. This is different from the requirements faced by other health care professionals such as physicians, dentists, chiropractors and optometrists, who must obtain approval from their respective regulatory college and a permit for a professional corporation.

NPs can form a corporation by following the Government of Alberta’s guidelines for incorporating a business, which can be found here. It is recommended to consult with the Canadian Nurses Protective Society, an accountant and a lawyer to explore the options available to you.

NP Prescribing

Nurse Practitioners (NPs) in Alberta must meet all CRNA standards applicable to their practice, including the Prescribing Standards for Nurse Practitioners, before prescribing any medication. This includes demonstrating appropriate knowledge, skill, and judgment, and ensuring prescribing aligns with evidence-informed practice and regulatory requirements.

What are the current restrictions for prescribing Dihydroepiandrosterone (DHEA)?

Also known as prasterone, DHEA is classified as an anabolic steroid under the Food and Drugs Regulations, which introduces additional prescribing considerations for NPs.

Federal vs Provincial Authorization: Although federal legislation permits NPs to prescribe DHEA for therapeutic use under Health Canada’s exemption for anabolic steroids, Alberta’s regulatory framework does not authorize NPs to do so with the exclusion noted in the Prescribing Standards for Nurse Practitioners (criterion 1.3). CRNA is in the process of updating the prescribing standards to align with federal legislation. Until these updates are finalized and approved, NPs must not prescribe DHEA.
Competence Requirements: While there is no mandatory course to prescribe hormone therapies, NPs must demonstrate competence in assessing, diagnosing, and managing patients receiving hormone therapy in accordance with evidence-based practice.
Clinical Judgment: Hormone therapy, including DHEA, is a complex and evolving area of practice. NPs must assess the clinical indication, consider other potential causes for symptoms, and refer to current evidence and clinical guidelines. Safe prescribing includes reassessing treatment effectiveness over time and monitoring for unintended effects.

More information: Health Canada: Exemptions for Nurse Practitioners

What education and training are required to prescribe Opioid Agonist Therapy (OAT)?

Nurse practitioners must meet requirements for education and/or preceptorship to prescribe OAT as per CRNA standards. Acceptable training programs include:

Can NPs prescribe psychedelics in Alberta?

Psychedelic substances, including ketamine, are highly regulated in Alberta. Before engaging in any psychedelic-assisted therapy, NPs must contact Alberta Health’s Compliance and Monitoring branch to confirm all licensing and regulatory requirements.

General provider licensing inquiries: (780)427-8740
Complaints or service concerns: (780) 422-4703
Toll-free (within Alberta): Dial 310-0000
Email: amh.cam@gov.ab.ca

NPs may prescribe ketamine if the drug is not prescribed as part of psychedelic-assisted psychotherapy (e.g., ketamine used for procedural sedation). NPs prescribing designated psychedelic drugs must do so in alignment with the Mental Health Services Protection Regulation and the Psychedelic Drug Treatment Services Standards.

NP Permits

What is changing with NP practice permits in Alberta?

Effective for the 2026-2027 renewal period, Alberta will transition from the three population-based NP permits (All Ages, Adult, Child) to a single NP permit. The new NP permit authorizes NPs to provide care across the lifespan and in diverse practice settings.

Does this affect neonatal NP permits?

No. The neonatal NP permit remains unchanged. Neonatal NPs are authorized to provide care only to neonates, based on population-specific education and clinical preparation.

How will this change affect my permit renewal for the 2026-2027 practice year?

If you hold an All Ages, Adult or Child NP permit, you will automatically be transitioned to the new NP permit during the 2026-2027 renewal period.
If you hold a neonatal NP permit, there will be no change to your permit or renewal process.

Will I have to meet new requirements to get the new permit?

No. You will complete your permit renewal as usual, provided you continue to meet the CRNA’s existing registration requirements.

Does the new NP permit mean I can work with any patient population right away?

No. The permit authorizes practice across the lifespan but solely holding a permit does not expand your competence. You are accountable for practising only in areas where you have the necessary knowledge, clinical training and experience to provide safe, competent and ethical care.

How do I become competent in a new area of practice?

You are responsible for ensuring you are prepared for safe, competent and ethical practice before changing or expanding your scope. Take reasonable steps such as:

Targeted education or certifications specific to new practice areas.
Mentorship and/or supervised clinical practice to build necessary competencies.

Maintain documentation that shows how you achieved and sustained competence (e.g., education, supervised practice, mentorship plans, evaluations). Experience alone is not enough if you do not meet the educational requirements for a specific practice area. This expectation applies to both new and experienced NPs and reflects your ongoing professional responsibility.

What if I want to change between NP and neonatal NP permits?

NP and neonatal NP permits are not interchangeable. To change permit types, you must:

successfully complete an approved entry-level NP education program for the new permit type, and
meet all CRNA registration and examination requirements.

A registrant may hold both NP permits if they meet the requirements and remain competent in both roles.

Why is this change happening?

This change is part of the national Nurse Practitioner Regulation Framework Implementation Plan Project (NPR-FIPP), which aims to align NP regulation across Canada. The goals are to support public protection, improve workforce mobility and provide clarity for NPs and the public.