Florida Board of Osteopathic Medicine » Links and Resources

Welcome to the Florida Board of Osteopathic Medicine Online Resources – a tool for accessing applications, forms, statutes, rules and other important information.

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As of July 2016 you may now submit an online application to expedite processing for the following licenses/registrations/certification:

1. Osteopathic Physician License Application
2. Osteopathic Physician Expert Witness Certificate
3. Osteopathic Physician/Resident In Training License Application
4. Temporary Certificate for Active Duty Military and Veterans Practicing in Areas of Critical Need
5. Temporary Military License For Spouses of Active Duty Members of the Armed Forces
6. Active Military, Veteran, or Spouse of Active Military (VALOR)

Forms & Requests

Physician Office Adverse Incident Report (pdf)

Fieldprint Applicant Scheduling Aid (pdf)

Osteopathic Physician Dispensing Application (pdf)

Cataract Operation Informed Consent (pdf)

Financial Responsibility Form (pdf)

Electronic Fingerprinting Form (pdf)

APRN/EMT/Paramedic Protocol Form (pdf)

Medical Marijuana Consent Form (pdf)

Statutorily required documentation

Information sent to Qualified Physicians – Feb 2019 (pdf)

Postgraduate Training Evaluation Form (pdf)

Statutorily Required Documentation-Smokable Medical Marijuana (pdf)

Electronic Prescribing Waiver (pdf)

Address Change Form (pdf)

Name Change Form (pdf)

Exhibit I Form (pdf)

Informed Consent Forms

Masculinizing Medications for Patients with Gender Dysphoria – Patient Information and Informed Consent Form (PDF)

Masculinizing Medications for Patients with Gender Dysphoria – Patient Information and Parental Consent and Assent for Minors (PDF)

Puberty Suppression Treatment for Patients with Gender Dysphoria – Patient Information and Parental Consent and Assent for Minors (PDF)

Surgical Treatment for Adults with Gender Dysphoria – Patient Information and Informed Consent (PDF)

Feminizing Medications for Patients with Gender Dysphoria – Patient Information and Informed Consent (PDF)

Feminizing Medications for Patients with Gender Dysphoria – Patient Information and Parental Consent and Assent for Minors (PDF)

PDF Applications

Application for Full Licensure (pdf)

Initial & Renewal of Registration as Resident/Intern/Fellow
Osteopathic Physician in Training (pdf)

Limited Licensure Application (pdf)

Osteopathic Physician Dispensing Application (pdf)

Temporary Certificate for Practice in an Area of Critical Need Application (pdf)

Medical Faculty Certificate (pdf)

Reactivation Request (pdf)

Temporary Application for Military Spouses (pdf)

Temporary Certificate for Active Duty Military and Veterans Practicing in Areas of
Critical Need (pdf)

Office Surgery Registration Applications and Forms

Office Surgery Registration ApplicationNEW

Office Surgery Registration Application CURRENTLY REGISTERED WITH THE DEPARTMENT – Complete the highlighted portions of the application. You may send the completed application to PMC_OSR@flhealth.gov

Physician Office Adverse Incident Report

Pause/Time-Out Form

Surgical Logs

You may send the completed application, including documentation, by mail:

Department of Health
Board of Medicine
Post Office Box 6330
Tallahassee, Florida 32314-6330

If you need assistance, please contact the board office at 850-245-4131 or send an email to PMC_OSR@flhealth.gov.

Pain Management Clinic Applications and Forms

Registration Application

Initial Licensure – Facility (Required)

Mandatory Insert for 456.0635 Questions – Facility

Data Reporting Form

Inspection Form

Application for Certificate of Exemption NEW

SUBMITTING THE APPLICATION FOR EXEMPTION FROM PAIN MANAGEMENT CLINIC REGISTRATION

You may send the completed application, including documentation, by mail:

Department of Health
Board of Medicine
Post Office Box 6330
Tallahassee, Florida 32314-6330

If you need assistance, please contact the board office at 850-245-4131 or send an email to PMC_OSR@flhealth.gov.

Associations & Organizations

American Medical Association
515 North State Street | Chicago, IL 60610
312.464.5000

American Osteopathic Association
142 East Ontario Street | Chicago, IL 60611
321.202.8000

Drug Enforcement Agency (DEA)
8400 Northwest 53rd Street | Miami, FL 33166
305.590.4870

Federation of State Medical Boards
400 Fuller Wiser Road, Suite 300 | Euless, TX 76039
817.868.4072

Florida Hospital Association (FHA)

Florida Osteopathic Medical Association (FOMA)
2544 Blairstone Pines Drive| Tallahassee, FL 32301
850.878.7364

National Board of Osteopathic Medical Examiners (NBOME)
2700 River Road, Suite 407 | Des Plaines, IL 60018
847.635.9955

National Practitioner’s Data Bank (NPDB)
Post Office Box 10832 | Chantilly, VA 22021
800.767.6732

Neurological Injury Compensation Association (NICA)
Post Office Box 14567 | Tallahassee, FL 32317-4567
850.488.8191

Florida Statutes & Administrative Codes

Click on Chapter or Rule to View

Florida Statutes

You will be connected to the Florida Legislature website, which is the official custodian of the statutes.

Chapter 120: Administrative Procedure Act
Chapter 456: Health Professions and Occupations: General Provisions
Chapter 459: Osteopathic Medicine

Florida Administrative Code (F.A.C.)

You will be connected to the Florida Department of State: State Library and Archives of Florida website, which is the official custodian of the administrative codes.

Rules: Chapter 64B15: Board of Osteopathic Medicine, Florida Administrative Code
Rules: Chapter 64B: Division of Medical Quality Assurance, Florida Administrative Code