How do I view and update my Profile ?
You can view, confirm, or make changes to the information that will be published in your practitioner profile . In carrying our legislative mandate to publish practitioner profiles, we want to ensure the information that we publish is accurate. Accordingly, we ask that you please review your profile for any changes, corrections, and/or omissions. If you see the statement “The practitioner did not provide this mandatory information”, please provide that information. We will not accept curriculum vitae or resumes in place of you providing specific information. Changes, excluding education and training, year began practicing, and liability claims, can be made to your profile electronically by following the instructions below. You may also submit changes by mail to the Department of Health, Licensure Support Services, 4052 Bald Cypress Way, Bin C-10, Tallahassee, Florida 32399-3260. Please note that Chapter 456.042, Florida Statutes, requires practitioners to update profile information within 15 days after a change of an occurrence in each section of your profile.
Attention Newly Licensed Practitioners
Chapter 456.041(7), Florida Statutes (link), requires you to submit changes to the department within thirty (30) days from receipt of this letter. If you do not make changes within thirty (30) days, your profile will be automatically published.
Once you have completed your review and made any necessary corrections, click on “Confirm Changes”. The Practitioner Confirmation Page will display the information that will be published online, at which time you must “Confirm” the profile again before the changes will be implemented.
Note: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
How do I complete the Physician Workforce Survey?
1. Login to online services by selecting your profession from the dropdown menu and entering your User ID and Password. The survey must be completed by allopathic and osteopathic physicians only.
a. Your User ID and Password were mailed with your initial license. Please look at the center section and refer to the Online Services Instructions, item #5.
b. If you do not have your User ID and Password, click on "Get Login Help".
2. Select "Physician Workforce Survey" on the left side of the page
3. Complete Physician Workforce Survey
How do I obtain a copy of the ophthalmology informed consent for cataract surgery form?
Section 458.351, Florida Statutes provides for the optional use of an Informed Consent Form for Cataract Operation with or without Implantation of Intraocular Lens developed and approved by the Boards of Medicine and Osteopathic Medicine.
As provided in Rule 64B8-9.017, Florida Administrative Code the Board-approved informed consent form is not executed until:
(1) The physician performing the surgery has explained the information in the consent form to the patient. Such physician is prohibited from delegating this responsibility to another person. The physician performing the surgery is also required to sign the informed consent form;
(2) The patient or the person authorized by the patient to give consent is required to sign the informed consent form; and
(3) A competent witness is also required to sign the informed consent form.
Cataract Operation Informed Consent (PDF)
Additional information regarding the use of the informed consent form can be found at Rule 64B8-9.017, FAC and s.458.351, FS.
How do I file my medical malpractice (financial responsibility) requirement with the Board of Medicine?
As a condition of licensing and maintaining an active license, and prior to the issuance or renewal of an active license or reactivation of an inactive license for the practice of medicine, an applicant must demonstrate to the satisfaction of the board and the department, financial responsibility to pay claims and costs ancillary thereto arising out of the rendering of, or the failure to render, medical care or services.
The licensee must notify the Board in writing of any change of status relating to financial responsibility compliance or exemption at least 10 calendar days prior to the change. In addition, the licensee is required to maintain such written documentation as may be necessary to prove his/her compliance with or exemption from financial responsibility requirements for a period of not less than 7 years.
Financial Responsibility options are divided into two categories, coverage and exemptions, pursuant to s. 458.320, Florida Statutes.
Using the Financial Responsibility Form, you will select only one option of the ten provided:
Coverage Options
1. I do not have hospital staff privileges and I have obtained and maintain professional liability coverage in an amount not less than $100,000 per claim, with a minimum annual aggregate of not less than $300,000 from an authorized insurer as defined under s.624.09, F. S., from a surplus lines insurer as defined under s. 626.914(2), F.S., from a risk retention group as defined under s. 627.942, F.S., from the Joint Underwriting Association established under s. 627.351(4), F. S., or through a plan of self-insurance as provided in s. 627.357, F.S. 2.
2. I have hospital staff privileges and I have professional liability coverage in an amount not less than $250,000 per claim, with a minimum annual aggregate of not less than $750,000 from an authorized insurer as defined under s. 624.09, F. S., from a surplus lines insurer as defined under s. 626.914(2), F. S., from a risk retention group as defined under s. 627.942, F.S., from the Joint Underwriting Association established under s. 627.351(4), F. S., or through a plan of self insurance as provided in s.627.357, F .S.
3. I do not have hospital staff privileges and I have established an irrevocable letter of credit or an escrow account in an amount of $100,000/$300,000, in accordance with Chapter 675, F. S., for a letter of credit and s. 625.52, F. S., for an escrow account.
4. I have hospital staff privileges and I have established an irrevocable letter of credit or escrow account in an amount of $250,000/$750,000, in accordance with Chapter 675, F. S., for a letter of credit and s. 625.52, F. S., for an escrow account.
5. I have elected not to carry medical malpractice insurance, however, I agree to satisfy any adverse judgments up to the minimum amounts pursuant to s. 458.320(5)(g) 1 or 459.0085(5)(g)1, F. S. I understand that I must either post notice in the form of a "sign" prominently displayed in the reception area or provide a written statement to any person to whom medical services are being provided that I have decided not to carry medical malpractice insurance. I understand that such a sign or notice must contain the wording specified in s. 458.320(5)(g) or 459.0085(5)(g), F. S.
Exemptions
1. I practice medicine exclusively as an officer, employee, or agent of the federal government, or of the state or its agencies or subdivisions. For the purposes of this subsection, an agent of the state, its agencies, or its subdivisions is a person who is eligible for coverage under any self-insurance or insurance program authorized by the provisions of s.768.28 (16).
2. I hold a limited license issued pursuant to s. 458.317 or 459.0075, F. S., and practice only under the scope of the limited license.
3. I do not practice medicine in the State of Florida. I understand that if I resume any practice of medicine in this state, I must notify the department of such activity and fulfill the financial responsibility requirements of Chapters 458, or 459, F.S. before resuming the practice of medicine in the State of Florida.
4. I meet all of the following criteria:
(a) I have held an active license to practice in this state or another state or some combination thereof for more than 15 years.
(b) I am retired or maintain part time practice of no more than 1000 patient contact hours per year.
(c) I have had no more than two claims resulting in an indemnity exceeding $25,000 within the previous five-year period.
(d) I have not been convicted of or pled guilty or nolo contendere to any criminal violation specified in Chapter 458 or 459, F. S.
(e) I have not been subject, within the past ten years of practice, to license revocation or suspension, probation for a period of three years or longer, or a fine of $500 or more for a violation of Chapter 458 or 459, F.S., or the medical practice act of another jurisdiction. A regulatory agency's acceptance of a relinquishment of license stipulation, consent order or other settlement offered in response to or in anticipation of filing of administrative charges against a license shall be construed as action against a license. I understand if I am claiming an exception under this section that I must either post notice in the form of a sign, prominently displayed in the reception area or provide a written statement to any person to whom medical services are being provided, that “I have decided not to carry medical malpractice insurance”. I understand such a sign or notice must contain the wording specified in s. 458.320(5) (f)7 or 459.0085(5)(f)7, F. S.
5. I practice only in conjunction with my teaching duties at an accredited medical school or its teaching hospitals. I understand that I may practice medicine to the extent that such practice is incidental to and a necessary part of my duties in connection with my teaching position in the medical school. (Interns and residents do not qualify for this exemption).
How do I establish protocols with an Advanced Registered Nurse, EMT or Paramedic?
A physician must submit notice to the Board when he/she enters into
• A formal supervisory relationship or standing orders with an emergency medical technician or paramedic licensed pursuant to s. 401.27, which relationship or orders contemplate the performance of medical acts, or
• An established protocol with an advanced registered nurse practitioner, which protocol contemplates the performance of medical acts identified and approved by the joint committee pursuant to s. 464.003(2) or acts set forth in s. 464.012(3) and (4), the physician shall submit notice to the board.
The physician shall file notice within 30 days of entering into the relationship, orders or protocol. Notice shall also be filed within 30 days after terminating the relationship, orders, or protocol
ARNP/EMT/Paramedic Protocol (PDF)
Mail the completed Protocol Form to:
Department of Health
Division of Medical Quality Assurance
Board of Medicine
4052 Bald Cypress Way, Bin C03
Tallahassee, FL 32399-3253
(850) 488-0596 FAX
Additional information regarding protocols can be found at s. 458.348, F.S.
How do I become a Department of Health Expert Witness?
Each year the Department of Health contracts with experts to review cases against medical professionals who may have failed to provide appropriate medical care such as is expected of a medical practitioner in the State of Florida. Being an expert witness for the Department not only helps to improve the efficiency of the disciplinary process, but also allows you to play an active role in helping to regulate your profession.
Experts must:
• Have a current Florida license;
• Be actively practicing in Florida;
• Shall not have ever been the subject of any disciplinary action by the medical licensing authority of any state or jurisdiction, and is currently; and
• Shall remain in good standing with the respective healthcare profession for which his or her services are required.
The Department offers two types of expert witness contracts.
• If you wish to provide your services pro bono, Board rules provide an official recognition for time spent in the review of a case and written opinion by awarding Continuing Medical Education (CME) Credits of 5.0 hours per case, up to a maximum of 15 hours per biennial license renewal period towards risk management. For services other than case review and written opinion, such as deposition and trial services, you will be compensated at a modest rate of $160.00 per hour.
• If you wish to be a paid expert, you will be compensated at a modest rate of $125.00 per hour for time spent in the review of a case and written opinion and $160.00 for deposition and trial services. Your deposition testimony would typically be paid by the opposing counsel at your requested fee.
• Additionally, the Department reimburses travel expenses in accordance with the Department of Health 40-1 (Official Travel of Department of Health Employees and Non-Employees.)
If you are interested in becoming an expert witness for the Department and your board, please click on the link below to fill-out and submit your application:
Board Expert Witness Application (PDF)
If you are a physician licensed in another state but do not hold a Florida medical license, and you plan to provide expert witness testimony in Florida, you must register for an Expert Witness Certificate. For more information, click on Apply located on this page.
How do I update my address?
1. Login to online services by selecting your profession from the dropdown menu and entering your User ID and Password
- Your User ID and Password were mailed with your initial license. Please look at the center section and refer to the Online Services Instructions, item #5.
- If you do not have your User ID and Password, click on "Get Login Help".
2. Select "Update Addresses" on the left side of the page
3. Enter the new address information
4. Once you have entered your new address, click on "Process".
5. You will receive a confirmation page that displays the updated address.
About Your Practice Location Address
The practice location address will display on the Internet and your license. Your practice location must be a physical location address and must not include a Post Office box. The mailing address will only display on the Internet if you have not provided a practice location address to us.
Establishment/Facility Name or Address
If the name or address change is for a facility that has changed location, a licensure application must be submitted. See your profession's web page for additional information.
How do I report an adverse incident?
Section 458.351, Florida Statutes requires any adverse incident that occurs on or after January 1, 2000, in any office maintained by a physician for the practice of medicine which is not licensed under chapter 395 be reported to the department. Any physician or other licensee under this chapter practicing in this state, involved in an adverse incident that occurred on or after January 1, 2000 in any office maintained by the physician for the practice of medicine which is not licensed under Chapter 395, must notify the Department of Health.
Adverse incidents must be reported within 15 days after the occurrence of the adverse incident.
To print an Adverse Incident Form online, click Forms under Resources located on this page.
Mail the completed Adverse Incident Form by certified mail to:
Department of Health
Consumer Services Unit
4052 Bald Cypress Way, Bin C75
Tallahassee, FL 32399-3275
For purposes of notification to the department, the term “adverse incident” means an event over which the physician or licensee could exercise control and which is associated in whole or in part with a medical intervention, rather than the condition for which such intervention occurred, and which results in the following patient injuries:
(a) The death of a patient.
(b) Brain or spinal damage to a patient.
(c) The performance of a surgical procedure on the wrong patient.
(d) 1. The performance of a wrong-site surgical procedure;
2. The performance of a wrong surgical procedure; or
3. The surgical repair of damage to a patient resulting from a planned surgical procedure where the damage is not a recognized specific risk as disclosed to the patient and documented through the informed-consent process if it results in: death; brain or spinal damage; permanent disfigurement not to include the incision scar; fracture or dislocation of bones or joints; a limitation of neurological, physical, or sensory function; or any condition that required the transfer of the patient.
(e) A procedure to remove unplanned foreign objects remaining from a surgical procedure.
(f) Any condition that required the transfer of a patient to a hospital licensed under chapter 395 from an ambulatory surgical center licensed under chapter 395 or any facility or any office maintained by a physician for the practice of medicine which is not licensed under chapter 395.
Additional information regarding Adverse Incidents can be found at s. 458.351, F.S and Rule 64B8-9.001, FAC.
How do I relinquish my license?
There are two types of license relinquishments. Rule 64B8-8.018, FAC provides that a Florida licensee may administratively relinquish the license at any time, provided there is:
• no investigation against the license already initiated;
• no investigation against the license anticipated;
• no disciplinary action against the license pending; and
• not current restrictions against the license by the Board of this state or any other jurisdiction
This type of administrative relinquishment shall not be considered disciplinary action against the license as that term is used in Section 458.331(1)(b), Florida Statutes.
To print a Voluntary Relinquishment Form online, click Forms under Resources located on this page.
Mail the completed Voluntary Relinquishment Form to:
Department of Health
Division of Medical Quality Assurance
Board of Medicine
4052 Bald Cypress Way, Bin C03
Tallahassee, FL 32399-3253
If a licensee wishes to voluntarily relinquish a license, but the licensee or the license is currently under any of the constraints set forth above, then the licensee may relinquish the license only with the approval of the Board of Medicine. If the voluntary relinquishment is accepted by the Board of Medicine, then the acceptance of the voluntary relinquishment of the license shall be considered disciplinary action against the license as that term is used in Section 458.331(1)(b), Florida Statutes, and shall be reported as such by the Board of Medicine. In addition, the licensee will be required to cease practice immediately upon signing the voluntary relinquishment and agrees to never reapply for licensure in Florida again.
How do I register as a Dispensing Practitioner?
Dispensing is defined as selling medicinal drugs to patients in the office. A practitioner who writes prescriptions or provides complimentary professional samples is not a “dispensing practitioner,” and therefore does not need to register with the department.
A practitioner authorized by law to prescribe drugs may dispense such drugs to her or his patients in the regular course of her or his practice in compliance with s. 465.0276, Florida Statutes.
Duly authorized agents and employees of the department shall inspect in a lawful manner at all reasonable hours any pharmacy, hospital, clinic, wholesale establishment, manufacturer, physician’s office, or any other place in the state in which drugs and medical supplies are manufactured, packed, packaged, made, stored, sold, offered for sale, exposed for sale, or kept for sale for the purpose of:
(a) Determining if any of the provisions of this chapter or any rule promulgated under its authority is being violated;
(b) Securing samples or specimens of any drug or medical supply after paying or offering to pay for such sample or specimen; or
(c) Securing such other evidence as may be needed for prosecution under this chapter.
To print a Dispensing Practitioner Form online, click Forms under Resources located on this page.
Fees:
Registration $100
Renewal $100
Mail the completed Dispensing Practitioner Form and $100 Fee* to:
Department of Health
Division of Medical Quality Assurance
Board of Medicine
PO Box 6320
Tallahassee, FL 32314-6320
* Cashier’s check or money order is required payable to Department of Health. Do not send cash.
Additional information regarding Dispensing Practitioners can be found at s. 465.0276, 465.017, F.S and Rule 64B8-3.006, FAC.
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 under Resources located on this 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.
