PA Council Application
Florida Academy of Physician Assistants (FAPA) is seeking applications for appointment to the Florida Council on Physician Assistants. The Florida Council on Physician Assistants is a five-member advisory body established under §459.022, Florida Statutes. It consists of three licensed Physician Assistants and two supervising physicians (one allopathic, one osteopathic). The Council advises the Boards of Medicine and Osteopathic Medicine on PA licensure, practice standards, and rulemaking. FAPA is seeking qualified applicants to fill a vacancy on the Council. The selected applicant will be formally recommended by FAPA to the Florida Department of Health for consideration. This does not guarantee a seat on the Council.
Application Process
Interested applicants must complete this application form in full and submit it, along with a current curriculum vitae (CV). Incomplete applications may not be considered.
Initial Review
The FAPA Elections and Nomination Committee (ENC) will review all submitted applications to verify eligibility, completeness, and compliance with statutory requirements under Florida Statutes.
Credentials and Qualifications Evaluation
Eligible candidates will undergo a review of professional credentials, licensure status,disciplinary history, and leadership or advocacy experience. The review will confirm that all applicants are in good standing with the Florida Department of Health and NCCPA.
Vetting and Selection by Committee
The FAPA ENC will conduct a vetting process to identify qualified candidate based on professional merit, service record, and alignment with the mission and goals of the Academy. References provided may be contacted as part of this process.
Interview Process
Selected finalists will be invited to participate in a virtual interview via Zoom with members of FAPA leadership/ENC. The interview will assess the applicant’s understanding of Council responsibilities, ethical standards, and commitment to advancing the PA profession in Florida.
Recommendation and Endorsement
Following the interview process, the FAPA ENC will make a formal recommendation for endorsement to the FAPA Board of Directors. The Board will vote to endorse applicant(s) for recommendation to the Florida Department of Health.
Submission to the Department of Health
The endorsed candidate(s) name(s) and supporting materials will be forwarded to the Florida Department of Health for consideration. Final appointment decisions are made by the Department and are not guaranteed by FAPA.
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
PA License Number and NCCPA Number
Type a label
AAPA member
yes
no
FAPA Member
yes
no
Current Employer: Practice Setting (e.g., hospital, private practice, academic, rural health):
Years in Practice as a PA: Specialty Area(s):
Supervising Physician(s):
Please list any leadership, teaching, or policy roles:
Describe your understanding of the role and responsibilities of the PA Council:
List any previous involvement in FAPA, AAPA, or other professional boards or committees:
Describe your experience with rulemaking, legislation, licensure, or regulatory matters:
What do you believe are the top priorities for the PA Council in the next two years?
How would your appointment contribute to advancing the PA profession and patient safety in Florida?
Do you currently serve on any board(s) or committee(s) that could present a conflict of interest?
yes
no
maybe
If yes or maybe, please explain.
Are you willing and able to attend Council meetings (typically held quarterly in Tallahassee or virtually)?
yes
no
Are you able to serve a full 4-year term, if appointed?
yes
no
Please list two professional references familiar with your work, ethics, or leadership: Name / Title / Contact:
Certification Statement: I certify that the information provided in this application is accurate and complete to the best of my knowledge. I understand that submission of this application does not guarantee selection or appointment.
SECTION VI: FAPA Endorsement (To be completed by FAPA Leadership) Endorsed by: Title/Position: Date of Endorsement: Signature:
Please attach your CV
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