Standards for Protocols/Collaborative Agreements: Physicians and ARNP

Posted in Latest News on May 9, 2013.

In Florida, an advanced registered nurse practitioner (ARNP) is defined by s. 464.003, Florida Statutes as “any person licensed in this state to practice professional nursing and certified in advanced or specialized nursing practice, including certified registered nurse anesthetists, certified nurse midwives, and nurse practitioners.” According to Rule 64B8-35.002, Florida Administrative Code, ARNP’s “shall only perform medical acts of diagnosis, treatment, and operation pursuant to a protocol between the ARNP and a Florida licensed physician, osteopathic physician or dentist.”

The protocol established between the ARNP and the physician must contain certain information as outlined in the rule noted above. In addition, the following language is required in the protocol:

I, (name and professional license number of physician) , of (address of physician) have hereby entered into a formal supervisory relationship, standing orders, or an established protocol with (number of persons) emergency medical technician(s), (number of persons) paramedic(s), or (number of persons) advanced registered nurse practitioner(s).

In the past, protocols were required to be submitted on a yearly basis and every time there was a change in the protocols. Effective May 6, 2013, a change in Rule 64B8-35.002, FAC will require the protocols to be submitted within thirty days of renewal of the ARNPs’s license and upon any change, including termination of the protocol. This change makes the rule consistent with the Board of Nursing requirements for protocols. Both the physician and the ARNP must maintain a copy of the protocol for a minimum of four years.

Protocols should be submitted to the Board of Medicine at 4052 Bald Cypress Way, Bin C03, Tallahassee, FL 32399 or faxed to the Board at (850) 488-0596.

A form, ARNP/EMT/Paramedic Protocol Form, is available at the Board of Medicine’s website at, Resources. If you have any questions, feel free to contact the Board at

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