Applications

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 you wish to download:

• Physician Assistant Application and Instructions (pdf - 54kb)

• NCCPA Verification Form (pdf - 5kb)
• License Verification Form (pdf - 7kb)
• Training Program Verification Form (pdf - 5kb)
• Supervision Data Form (pdf - 64kb)
• Application for Licensure as a Prescribing Physician Assistant (pdf - 61kb)

Additional Applications or Forms:

• Request Change to Prescribing Physician Assistant License (pdf - 109kb)

• Request Extension of Temporary Physician Assistant licensure (pdf - 78kb)

• The Federation of State Medical Boards provides primary source verification of Physician Assistant’s credentials, which is acceptable by the Florida Board of Medicine. For information on how to establish a permanent lifetime portfolio of primary source verification call the Federation Credentials Verification Service at (888) 275-3287 or visit their web site at www.fsmb.org
• The title "Physician Trained Assistant" is not recognized in the State of Florida.
• NOTE: Upon completion, applications are approved and licenses are immediately issued by the Board staff and then ratified by the Council on Physician Assistants at the next scheduled meeting.
• Applicants requiring a personal appearance with the Council will be on hold for a license determination until after the Council meeting.
• Submit proof of a passing score on the proficiency examination of the NCCPA direct from the source. Applicants who have not actively practiced as a physician assistant within the immediately preceding four years and who do not hold a current certificate issued by the NCCPA must retake and successfully complete the entry-level examination of the NCCPA. If you did not pass the NCCPA PANCE examination within 5 attempts and have not practiced as a fully licensed physician assistant, an approved review course will be required prior to licensure. See rule 64B8-30.003(2), Florida Administrative Code.

Learn more about Physician Assistants licensure in Florida.