1. (1) A health care professional not licensed in this state who intends to provide health care services via telehealth to a patient located in this state must register with the appropriate board, or the department if there is no board, using form DH5037-MQA-11/2022, Application for Out-of-State Telehealth Provider Registration, incorporated by reference and available at HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-16084"http://www.flrules.org/Gateway/reference.asp?No=Ref-16084.
2. (2) Out-of-state licenses must be verified by the issuing state, territory or District of Columbia using form DH5041-MQA-07/2019, License Verification Request Out-of-State Telehealth Provider, incorporated by reference and available at HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-11687" https://www.flrules.org/Gateway/reference.asp?No=Ref-11687.
3. (3) Changes to the registered agent designated in the application must be reported to the department on form DH5038-MQA-07/2019, Change of Registered Agent and/or Registered Office Out-of-State Telehealth Provider, incorporated by reference and available at HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-11688" https://www.flrules.org/Gateway/reference.asp?No=Ref-11688.
4. (4) Changes made to required financial responsibility coverage must be reported to the department on form DH5039-MQA-07/2019, Change of Financial Responsibility Form Out-of-State Telehealth Provider, incorporated by reference and available at HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-11689" https://www.flrules.org/Gateway/reference.asp?No=Ref-11689.

Rulemaking Authority 456.004(5), 456.47(4)(b)1., (7) FS. Law Implemented 456.47 FS. History–New 12-12-16, Amended 3-16-20, 12-7-23.