The applications and materials are available for you to download
directly to your computer. The files are in a PDF file format, which
requires Adobe PDF Reader to download. These will open in a new browser window. Simply
click on the applications or forms (PDF format) you wish to download:
Click here to see who is listed as your supervising physician(s).
Frequently requested forms:
- Address Change Form (pdf - 40kb)
- Financial Responsibility Form (pdf - 27kb) (Updated 6/2005)
S. 458.320(1)(b) Financial
Responsibility, explains that your professional liability coverage
must be with an authorized insurer. s.624.09, F.S. defines an
“authorized” insurer is one duly authorized by a subsisting
certificate of authority issued by the office to transact
insurance in this state.
The Department of Financial Services provides a web site listing
only authorized insurers pursuant to s. 624.09. http://www.fldfs.com/data/companysearch/index.asp
Before choosing an insurance carrier, review the web site to
insure compliance with the Florida Statutes.
- Anesthesiologist Assistant Protocol Form (pdf - 95kb)
CE Broker
Benefits to Licensees (pdf - 108kb)
Did you Know? (pdf - 63kb)
Continuing Education Information (doc - 51kb)
How Do I Change My Name, Address or Request a
Duplicate License?
Obtain a Written License Certification
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