Examination Eligibility Requirements:
Application Completion: The applicant must complete the application for licensure by accurately answering all questions and attaching all required supporting documentation.
The Board of Podiatric Medicine will consider denial of any application that is submitted with incomplete or inaccurate information disclosures related to criminal history or discipline. Applicants must disclose all information accurately, completely, and include all required documentation.
Training Confirmation: The applicant must submit documentation verifying completion of a board-approved training course and passing scores on the examination administered by the Florida Podiatric Medical Association (FPMA).
Supervisor Designation: The applicant must disclose the current supervisor upon initial application. Change in supervisor must be reported to the board by the podiatric x-ray assistant within 30 days of the change. This change must be documented on the Certified Podiatric X-ray Assistant Supervisor Update Form and submitted with the $25.00 fee.
Read Affirmation and Sign Application: The applicant must affirm by signing the application that: “I have carefully read the questions in the foregoing application and have answered them completely, without reservations of any kind, and I declare under penalty of s. 461.012(2)(b), Florida Statutes, that my answers and all statements made by me herein are true and correct. Should I furnish any false information in this application, I hereby agree that such act shall constitute cause for denial, suspension or revocation of my license to practice Podiatric Medicine in the State of Florida.”
Background Screening: The applicant must complete a criminal background screening pursuant to section 456.0135, Florida Statutes, by submitting fingerprints electronically through a service provider approved by the Florida Department of Law Enforcement. For more information or to locate a live scan provider visit:
http://www.flhealthsource.gov/background-screening. The background screening is a health care profession background and will identify all criminal background information both in-state and out-of-state.
Applicants with Health History
If a “yes” response is provided to any of the health history questions on the application, the applicant is required to submit supporting documentation including the relevant dates and circumstances and the names and addresses of the medical practitioners or hospitals who performed related treatments. The application is considered incomplete until all supporting documentation is provided to the department.
Applicants with License Discipline History
Applicants with prior disciplinary actions on any license from any state are required to submit the following supplemental documentation:
Board Actions – Certified copies of documents relative to any disciplinary action taken against any license. The documents must be certified and submitted by the agency or board that finalized the disciplinary action.
Self-Explanation – Applicants who have listed license discipline on the application must submit a letter to the board personally describing the circumstances that led to the disciplinary action. The letter should also include a thorough description of the rehabilitation taken by the applicant since the time of the event which would facilitate prevention of future occurrences.
Applicants with Criminal History
Applicants who have been convicted of a misdemeanor or felony; or entered a plea of guilty, nolo contendere, or no contest to any crime in any jurisdiction; even if adjudication was withheld by the court; must answer the criminal history questions on the application and provide the following supplemental documentation:
Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, a letter on court letterhead must be sent from the clerk of the court attesting to records unavailability.
Completion of Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, a letter on court letterhead must be sent from the clerk of the court attesting to records unavailability.
Self-Explanation – Applicants who have listed offenses on the application must submit a letter personally describing the circumstances of the offense. The letter must include the date of the original offense, the charge, and the jurisdiction where the incident occurred.
Electronic Fingerprint - Background Screening
The applicant must complete a criminal background screening pursuant to section 456.0135, Florida Statutes, by submitting fingerprints electronically through a service provider approved by the Florida Department of Law Enforcement. The results will be returned to the Care Provider Background Screening Clearinghouse and are made available to the Department for review during the licensure process. Applicant fingerprints will be retained by FDLE and the Clearinghouse. All costs for conducting criminal history background screening and the retention of fingerprints are the responsibility of the applicant.
It is important to use the correct Originating Agency Identification (ORI) when submitting fingerprints. If an incorrect ORI number is provided to the Livescan service provider, the Department will not receive the results.
The ORI number for the Board of Podiatric Medicine is EDOH2017Z.
The applicant is responsible for selecting an approved Livescan Service Provider and for ensuring the results are reported to the Department. Print the electronic fingerprinting form, complete the information, and take the form to a Livescan Service Provider. Upon completion of electronic fingerprinting, document the Transaction Control Number. This number is useful to track the fingerprint records in the event they are not properly transmitted to the Department.
For more information, frequently asked questions, and a list of all approved Livescan Service Providers, visit the Background Screening website at: http://www.flhealthsource.gov/background-screening.
Health Care Fraud; Disqualifications for License, Certificate, or Registration
Effective July 1, 2012, Section 456.0635, Florida Statutes (F.S.), provides that health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant:
- Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S., (relating to social and economic assistance), Chapter 817, F.S., (relating to fraudulent practices), Chapter 893, F.S., (relating to drug abuse prevention and control) or a similar felony offense(s) in another state or jurisdiction unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration, unless the sentence and any subsequent period of probation for such conviction or plea ended:
- For the felonies of the first or second degree, more than 15 years from the date of the plea, sentence and completion of any subsequent probation;
- For the felonies of the third degree, more than 10 years from the date of the plea, sentence and completion of any subsequent probation;
- For the felonies of the third degree under section 893.13(6)(a), F.S., more than five years from the date of the plea, sentence and completion of any subsequent probation;
- Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues), unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;
- Has been terminated for cause from the Florida Medicaid program pursuant to section 409.913, F.S., unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent five years;
- Has been terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years before the date of the application;
- Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities.
Apply Online: Submit completed application and fees to the board office. Select the “Apply Online” button above. Once you have submitted your application you can check the status online. Select “Status” from the menu on the top right hand side the page.
Paper Application: If you prefer to apply using the paper application, please download, print and complete the paper application and submit along with your fees to the address listed below:
Florida Board of Podiatric Medicine
P. O. Box 6330
Tallahassee, FL 32314-6330
If you responded “yes” to any of the Health History questions on the application, submit a letter to the board office providing the relevant dates and circumstances of the treatment and/or addiction and include the names and addresses of the medical practitioners or hospitals that performed your treatment.
If you responded “yes” to any of the Discipline History questions on the application, contact the state board where the discipline occurred to request that certified copies of the board order and any other documents relative to the disciplinary action be submitted directly to the board office. You must also submit a letter in your own words describing the circumstances of the offense. Your letter must include the date of the original offense, the charge and the jurisdiction where it occurred.
If you responded “yes” to any of the Criminal History questions on the application, contact the clerk of courts in the jurisdiction in which the offense occurred and request that a certified copy of your final/official court disposition be mailed directly to the board office. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.
If applicable, request for the following documentation to be sent directly to the board office:
- A certified copy of your completion of probation and documentation showing that you have paid all fines; if the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.
- You must also submit a letter in your own words describing the circumstances of the offense. Your letter must include the date of the original offense, the charge and the jurisdiction where it occurred.
Within 7-14 days of receipt of your application, the board office will notify you of the status of your application and any remaining required documents that needs to be submitted.
Make certified check or money orders payable to the “Department of Health.” Applicants applying online may use a major credit card or debit card.
|Licensure Certification fee||$75.00|
|Unlicensed Activity fee||$5.00|
Certified Podiatric X-ray Assistant – Change in Supervisor
Click on Chapter or Section Number to View
Chapter 461: Podiatric Medicine Practice Act
Chapter 456: Health Professions and Occupations: General Provisions
Chapter 120: Administrative Procedure Act
Chapter 119: Public Records
Chapter 408: Health Care Administration
Chapter 112: Public Officers and Employees: General Provisions
Florida Administrative Code (F.A.C.)