Supervision Data Form – Fill Out and Use This PDF

Supervision Data Form PDF Details

In the dynamic and regulated sphere of healthcare, the Supervision Data Form emerges as a vital document especially designed for physician assistants operating within the boundaries of Florida. This mandatory form, which needs to be updated promptly in the event of employment changes or modifications in supervisory channels, acts as a formal declaration to the Department, specifically under the stringent requirements laid out in sections s. 458.347(7)(e) and s. 459.022(7)(d), F.S. It essentially functions as a bridge between physician assistants and the governing bodies, ensuring that each assistant’s practice is under the appropriate supervision, thus upholding the high standards of healthcare provision. The form demands detailed information including but not limited to the physician assistant's license number, current mailing address, practice locations, and the credentials of supervising physicians. Not only does it facilitate a structured mechanism for adding or deleting supervisory physicians, but it also extends to the adjustment of practice locations. An inherent feature of the form is its requirement for the physician assistant's signature, underscoring the gravity and personal accountability associated with these submissions. With an aim to streamline communications and maintain up-to-date records, the process encapsulated within the DH-MQA 2004, Rules 64B8-30.003 and 64B15-6.003, underscores a comprehensive strategy to regulate and monitor the evolving professional landscapes physician assistants navigate.