Form E - Aa Basic Job Description - Physician Anesthesiologist Assistant Page 2
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3PHYSICIAN ANESTHESIOLOGIST ASSISTANT JOB DESCRIPTION
PAGE 2
(ii)
Where life-threatening emergencies arise necessitating the utilization of standard
therapeutic or resuscitation procedures; and anesthesiologist will be immediately
available personally or via telephone and/or beeper if needed for consultation
regarding changes from standard procedure.
Listed above are the duties approved by the Georgia Composite Medical Board as a basic job
description for Physician Anesthesia Assistants. Any additional duties must be requested on an
“Additional Duties Form” supplied by the Medical Board. Any additional duties must be individually
approved by the Medical Board BEFORE those duties may be performed by the Physician
Anesthesiologist Assistant.
Please type or “print legibly”
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Physician Assistant Name
License #
Physician Assistant Signature
Date
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Supervising Physician Name
License #
Supervising Physician Signature
Date
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Employer Address
City
State
Zip Code
The following physicians are designated as alternate supervising physicians for the Physician Assistant
listed above.
EACH LINE FOR ALTERNATE PHYSICIAN’S MUST BE COMPLETED.
DO NOT
SUBMIT SEPARATE FORMS FOR EACH ALTERNATE PHYSICIAN.
Please type or “print legibly”
Alternate Physician’s Name
License #
Original Signature
Date
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Form E – AA Basic Job Description – Physician Anesthesiologist Assistant
Revised: 12/2009
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An Equal Opportunity Employer
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