INFORMATION ON WHEN TO COMPLETE
SUPERVISION DATA FORMS

The Florida statutes are very specific on when PAs must submit a new "Supervision Data Form". You have thirty (30) days to submit a new "Supervision Data Form" after a change occurs in the status of a supervising physician. If you add a physician, delete a physician, add a practice setting or delete a practice setting you must submit a new "Supervision Data Form" when one of these changes occur. It is YOUR personal responsibility to do so, no one else. No excuse is acceptable. Yours' is the signature on the form and on your license. Do not take chances and delegate this to anyone else to do for you. It is just too important.

A physician can be a supervising physician only if they have a license in good standing. This means they cannot have any probations or limitations on their license and be a supervising physician. The law is very specific on this issue. If a supervising physician has died and you have not removed them as a supervising physician by submitting a new form, then you are in violation of the statute and subject to disciplinary action. If a physician left the practice or moved out of state then you need to submit a new form. If a new physician is added to the group or practice and even occasionally acts as a supervising physican, you must submit an updated form.

Also remember that if you are a prescribing physician assistant that you must submit the form, "Application for Changes to Licensure As A Prescribing Physician Assistant" if there are changes in your supervising physicians who supervise your prescribing of medications as well. You cannot prescribe under a new physician or setting until you have received the form back from the PA Council office indicating the changes are on file and approved, and you have in your possession a letter from the Board that you may prescribe under the new supervising physicians.

Our legal counsel encourages any PA who is not absolutely certain that his or her disclosure of supervising physician(s) is up to date, immediately prepare and file the proper forms disclosing each of your current supervising physicians. There is no harm in over reporting, however, a mistaken belief that reporting is current, when it is not, will likely carry a financial penalty. The Board of Medicine can impose a fine of $250 for each omission or error on the form. If you do not delete one physician and do not add a new one, that will be two errors and subject to a $500 fine.

Here is a link to the "Supervision Data Form" page on the state website.

Supervision Data Form

Here is a link to the "Application for Changes to Licensure As A Prescribing Physician Assistant" form page on the state website.

Application for Changes to
Licensure as a Prescribing Physician Assistant

You can fax them a request IN WRITING, and they will send you a faxed copy of your current supervision data form that you may check for accuracy. Their fax number is 850-488-0596.

Written by Ron Pace, PA-C
September 2005