Pain Management Clinics Application for Certificate of Exemption

Posted in Latest News on November 1, 2018.

Application for Certificate of Exemption NEW

SUBMITTING THE APPLICATION FOR EXEMPTION FROM PAIN MANAGEMENT CLINIC REGISTRATION

You may send the completed application, including documentation, by mail:

Department of Health
Board of Medicine
Post Office Box 6330
Tallahassee, Florida 32314-6330

If you need assistance, please contact the board office at 850-245-4131 or send an email to MQA.Medicine@flhealth.gov.



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Supporting Documents

Medical Degree Verification
NICA FORM
Postgraduate Training Verification
License Verification

Supporting Documents - Visiting Physician

NICA FORM