Advanced nursing practice is defined as the performance of advanced level nursing practice activities that, by virtue of post basic specialized education and experience, are appropriate to and may be performed by an APRN. For the first 3 years after having been issued a license and no less than 2,000 hours of practice, NPs must perform acts of diagnosis and treatment of alterations in health status in collaboration with a physician. The collaboration must address a reasonable and appropriate level of consultation and referral, coverage for the patient in the absence of the APRN, a method to review patient outcomes and a method of disclosure of the relationship to the patient. The collaborative agreement must be in writing and include the level of schedule II and III drugs that the NP may prescribe and a method to review patient outcomes.