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.

IMPORTANT - The Department of Health has adopted a rule (64B-3.004, F.A.C) (pdf - 39kb)

Simply click on the applications or forms you wish to download:

• Physician Assistant Application and Instructions (pdf - 229kb)

• NCCPA Verification Form (pdf - 44kb)
• License Verification Form (pdf - 34kb)
• Training Program Verification Form (pdf - 23kb)
• Supervision Data Form (pdf - 63kb)
• Application for Licensure as a Prescribing Physician Assistant (pdf - 83kb)

Additional Applications or Forms:

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

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

Application Requests

Request extension of Temporary Physician Assistant licensure
Physician Assistant both temporary and full licensure
Licensed Physician Assistants, Prescriptive Privileges

Learn more about Physician Assistants licensure in Florida.