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ARNP/EMT/Paramedic Protocol Form - Florida Board of Medicine

Paramedic Protocol Form - Florida Board of Medicine 2025

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The document outlines a collaborative practice protocol between Jane Doe, an Advanced Registered Nurse Practitioner (ARNP), and John Smith, a supervising physician, for providing psychiatric and mental health services in Florida. It details the responsibilities of the ARNP, including managing mental health care, initiating treatments for various psychiatric conditions, and prescribing non-controlled medications. The protocol emphasizes the need for supervision by the physician and establishes guidelines for referrals and evaluations of complex cases.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in the 'Requiring Authority' section, ensuring you reference Chapter 464 and Rule 64B9-4 accurately.
In the 'Parties to Protocol' section, enter the names and details of both the ARNP and supervising physician, including their addresses and license numbers.
Detail the 'Nature of Practice' by outlining the services provided under supervision, focusing on mental health care responsibilities.
Complete the 'Description of Duties' section, specifying tasks such as monitoring drug therapies and conducting evaluations.
Fill in any specific conditions for direct evaluation that may arise outside the ARNP's training scope.
Finally, ensure all parties sign and date the document in the designated area before submission.

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