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.
