Florida Department of State and Division of Library and Information Services
Notice: 31205887
Final Adopted Version in F.A.C.
Department: DEPARTMENT OF HEALTH
Division: Division of Public Health Statistics and Performance Management
Chapter: CONRAD 30 WAIVER PROGRAM

VIEW NOTICE

Overview
RULE:
64W-1.004   Application Requirements
RULE FILE DATE: 8/3/2026
RULE EFFECTIVE DATE: 8/23/2026
HISTORY NOTES: Rulemaking Authority 381.4018(3) FS. Law Implemented 381.4018 FS. History–New 8-12-21, Amended 10-24-22, 8-23-26.
OVERSIGHT COMMITTEE: Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)
RELATED COURT CASES: Division of Administrative Hearings
FEDERAL RULES
AND REGULATIONS: 		Electronic Code of Federal Regulations
HOW TO LINK TO
THIS NOTICE: 		http://flrules.org/gateway/ruleno.asp?id=64W-1.004&Section=0
REFERENCE MATERIALS: Ref-13378 DH8010-PHSPM-07/2021
Ref-13379 DH8011-PHSPM-07/2021
Ref-19553 Florida DOH Sponsorship Application (DH8006-PHSPM-04/2026)
Ref-19554 Physician Agreement (DH8007-PHSPM-04/2026)
Ref-19555 Physician Attestation of Exclusivity (DH8008-PHSPM-04/2026)
Ref-19556 Employer Practice Location Attestation(s) (DH8009-PHSPM-04/2026)


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