Florida

Board

of

Medicine

Physician Assistant Prescribing Notification (PDF)

Medical Doctor – Financial Responsibility Form (PDF)

Cataract Operation Informed Consent (PDF)

Medical Doctor Dispensing Registration (PDF)

Physician Office Adverse Incident Report (PDF)

APRN/EMT/Paramedic Protocol (PDF)

Physician Assistant Dispensing Form (PDF)

Anesthesiologist Assistant Protocol Form (PDF)

Anesthesiologist Assistant Financial Responsibility Form (PDF)

CME Requirements for Renewal of Physician Assistant License (PDF)

Medical Marijuana Consent Form (pdf)

Statutorily Required Documentation

Information sent to Qualified Physicians – Feb 2019 (pdf)

Summary of Physician Licensure Types

Statutorily required documentation – Smokable Medical Marijuana

Electronic Prescribing Waiver (PDF)

Exhibit I Form

Physician Assistant Program Verification Request (PDF)

General Forms

Address Change Form (PDF) (Optional)

Name Change Form (PDF) (Optional)

Expert Witness Application – Work for the Department

Informed Consent Forms

Masculinizing Medications for Patients with Gender Dysphoria – Patient Information and Informed Consent Form (PDF)

Masculinizing Medications for Patients with Gender Dysphoria – Patient Information and Parental Consent and Assent for Minors (PDF)

Puberty Suppression Treatment for Patients with Gender Dysphoria – Patient Information and Parental Consent and Assent for Minors (PDF)

Surgical Treatment for Adults with Gender Dysphoria – Patient Information and Informed Consent (PDF)

Feminizing Medications for Patients with Gender Dysphoria – Patient Information and Informed Consent (PDF)

Feminizing Medications for Patients with Gender Dysphoria – Patient Information and Parental Consent and Assent for Minors (PDF)

Medical Doctor Application by Examination

Mobile Opportunity by Interstate Licensure Endorsement (MOBILE)

Intern/Resident/Fellow & House Physician – Registration & Renewal

Graduate Assistant Physician

Limited License Application

Area of Critical Need Application

Rear Admiral Leroy Collins Jr. Temporary Certificate for Active Duty Military and Veterans Application

Medical Faculty Certificate Application

Temporary Certificate for Visiting Physician (Plastic Surgery/Other Medical/Surgical Trn.)

Temporary Certificate for Visiting Physicians in Cancer Centers

Public Health Certificate

Public Psychiatry Certificate

Physician Assistant Initial Application

Mobile Opportunity by Interstate Licensure Endorsement (MOBILE)

Physician Assistant Temporary Certificate to Practice in an Area of Critical Need

Extension of Temporary Physician Assistant Licensure Application

Anesthesiologist Assistant Application (PDF)

Mobile Opportunity by Interstate Licensure Endorsement (MOBILE) (PDF)

Office Surgery Registration Application

MQA Online Services Portal:  Professional Liability Coverage User Guide

Office Surgery Registration Signature Page

Physician Office Adverse Incident Report

Pause/Time-Out Form

Surgical Logs

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 PMC_OSR@flhealth.gov.

Registration Application

Mandatory Insert for 456.0635 Questions – Facility

Data Reporting Form

Inspection Form

Application for Certificate of Exemption

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 PMC_OSR@flhealth.gov.

Professionals Resource Network

American Medical Association

American Association of Physician Specialists/American Board of Physician Specialties

American Board of Interventional Pain Physicians

Federation of State Medical Boards

Florida Hospital Association

Florida Medical Association

Florida Society of Anesthesiologists

Florida Academy of Anesthesiologist Assistants

Click on Chapter or Section Number to View

Florida Statutes

Chapter 458: Medical Practice

Chapter 456: Health Professions and Occupations: General Provisions

Chapter 120: Administrative Procedure Act

Chapter 395: Hospital Licensing and Regulation

Chapter 400: Nursing Homes and Related Health Care Facilities

Chapter 893: Drug Abuse Prevention and Control

Florida Administrative Codes

Chapter 64B8: Board of Medicine

Chapter 64B: Division of Medical Quality Assurance

Physicians Assistant Workforce Survey Report
2022 – 2024 Physician Assistant Workforce Survey (pdf)

Guide to Florida’s Practitioner Profile

BOM Annual Reports
2015-2016 (pdf)
2013-2014 (pdf)
2012-2013 (pdf)
2011-2012 (pdf)
2010-2011 (pdf – 175kb)
2009-2010 (pdf – 198kb)
2008-2009 (pdf – 147kb)

Board Brief

June 2012 Message

May 2012 Message
(pdf – 25kb)
April 2012 Message
(pdf – 25kb)
February 2012 Message
(pdf – 25kb)
December 2011 Message
(pdf – 25kb)

October 2011 Message
(pdf – 25kb)
June 2011 Message
(pdf – 54kb)
May 2011 Message
(pdf – 33kb)

January 2011 Message
(pdf – 42kb)

Physician Certification Pattern Review Panel Annual Report
January 1, 2019 Report
(pdf – 6.9mb)

January 1, 2020 Report
(pdf – 4kb)

January 1, 2021 Report
Physician Certification Pattern Review 2021 Annual Report
(pdf – 2mb)

Data Tables for Physician Certification Pattern Review 2021 Annual Report
(pdf – 3mb)

January 1, 2022 Report
Physician Certification Pattern Review 2022 Annual Report
(pdf – 1.7mb)

Data Tables for Physician Certification Pattern Review 2022 Annual Report
(pdf – 2.9mb)

January 1, 2023 Report
Physician Certification Pattern Review 2023 Annual Report
(pdf – 2.23mb)

Data Tables for Physician Certification Pattern Review 2023 Annual Report
(pdf – 5.2mb)

January 1, 2024 Report
Physician Certification Pattern Review 2024 Annual Report
(pdf – 8.1mb)

Data Tables for Physician Certification Pattern Review 2024 Annual Report
(pdf – 9.2mb)

Information on Nonopioid Alternatives for the Treatment of Pain

Compliance Management

Human Trafficking

Background Screening

Declaratory Statements/Variance

MQA Online Services

Report cases, disease or condition public health significance

Livescan Service Providers

Counterfeit-Proof Prescription Pad Vendors

Florida’s Prescription Drug Monitoring Program (E-FORCSE)

Healthcare Integrity and Protection Data Bank (HIPDB)

Practitioner Profile

Public Records

FLHealthSource

License Certification

License Look-Up

Reports and Publications

Radon Guide for Health Care Providers

HIPAA Federal agency sources:
HHS.Gov- Health Information Privacy

HIPAA Statute and Rule Information:
HHS.Gov- HIPAA Statute and Rule Information

Donation and Human Transfer of Human Tissue pamphlet

Office of Medical Marijuana Use Website

January 1, 2019 Physician Certification Pattern Review Panel Annual Report

January 1, 2020 Physician Certification Pattern Review Panel Annual Report

Know the Facts about Patients (pdf)

Know the Facts about Qualified Physicians (pdf)

Know the Facts about Legal Use (pdf)

Medical Marijuana Consent Form (pdf)

Statutorily required documentation

Statutorily required documentation – Smokable Medical Marijuana

What the Practitioner Should Know about Certifying Cause of Death on the Florida Death Certificate (pdf)

Electronic Death Registration System EDRS Informational Brochure (pdf)

Computer Use and Confidentiality Agreement (pdf)

Citrix Remote Access Form (pdf)