How to Apply

Please explore the tabs at the top of the page for the information about the program. If you decide to participate in our program, please email for application forms, and send the following along with your application.

  • Complete and sign the Physician Application*
  • Non refundable $3000.00 deposit made payable to¬† “The University of Florida”
  • Very detailed CV with any board certifications and license numbers
  • Brief description of your current scope of practice
  • Copy of current Medical License
  • Complete complaint, consent, and final order (if you do not have this we will request it from the board)
  • Patient listing of last 100 patients seen (from this list we will randomly pick 15 charts and request copies)
  • Copy of the Patient file the complaint or complaints refer to
  • Completed Clinical Practice Survey*

*Please email for the Physician Application and Clinical Practice Survey

Once we receive everything we will start the process of review of the packet of information. If for some reason we are not able to evaluate your case we will let you know as soon as possible. The process of scheduling you to come here to the University of Florida for the 2-3 day evaluation takes a few weeks to a month or so depending on your specialty and our availability. You will hear from us throughout this process. If you have questions or concerns please feel free to contact us at any time.

PO Box 100288
Gainesville, FL 32608
(352) 273-9063
Fax (352) 846-0314