Help Center / How do I notify the Department of Health of any supervising physician changes?

Pursuant to s. 458.347(7)(e) and s. 459.022(7)(d), F.S., upon employment, a licensed physician assistant must notify the department in writing within 30 days after such employment and after any subsequent changes in supervision.

To print a Supervision Data Form online, click “Forms & Requests” on the Resources page.

Mail the completed Supervision Data Form to:

Department of Health
Council on Physician Assistants
4052 Bald Cypress Way, Bin #C-03
Tallahassee, Florida 32399-3253

Additional information regarding Supervision Data Forms can be found at s. 458.347, F.S and Rule 64B8-30.003 – .004 FAC.

Supporting Documents

Medical Degree Verification
Postgraduate Training Verification
License Verification

Supporting Documents - Visiting Physician