Notice of Change/Withdrawal

Board of Medicine
64B8-51.001: Manner of Application
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 37 No. 49, December 9, 2011 issue of the Florida Administrative Weekly.

These changes are being made pursuant to comments received from the Joint Administrative

Procedures Committee: The changes are as follows:

The PURPOSE and EFFECT: The purpose and effect of the amendments is to update and clarify, and to change the amended date of, the licensure application.

The SUMMARY: The rule amendments update the date of form DOH-MQA 1164, the form’s contact and application information, statutory references; deletes the requirement for a photograph; and amends questions to be answered by the applicant A notice of change was published January 20, 2012, setting forth the procedure for requesting a public hearing on the rule.

This amendments provides the new revised date of the application, and corrects the coding of the rule text which includes no changes to subsections (2) and (3), and will read as follows:

(1) All persons applying for licensure as an electrologist shall submit a signed application to the Executive Director of the Council on forms provided by the Council and approved and incorporated herein by reference by the Board as Form DH-MQA 1164, 02/12 8/09, Electrologist Application, which can be accessed through The initial application must be accompanied by the application fee, as set forth in Rule 64B8-51.007, F.A.C.

(2) through (3) No change.

Section 478.46, 478.47, 478.53 and 478.055, Florida Statutes, will be added to the Law Implemented.

With respect to Form DH-MQA 1164, Electrologist Application, Revised 01/11:

On the first page of the application, under “Temporary Permits”, the instructions incorrectly refers applicants requesting a temporary permit to Section 3. The text has been amended, to read as follows:

Temporary permits may be requested if you wish to practice electrolysis prior to examination and/or licensure. See section 4 3 of the application form.

The section “Special Testing Accommodations” has been amended to provide the appropriate contact information, and will read as follows:

Candidates requiring special testing accommodations will need to apply directly with the testing vendor. Current contact information for the testing vendor is maintained on the Council’s website at the following address:

In Section 15 “Statement of Applicant”, the first (1st) paragraph, are amended to read as follows:

I declare these statements are true and correct and recognize that providing false information may result in disciplinary action against my license or criminal penalties pursuant to Sections 456.067, 775.083 775.0083 and 775.084, Florida Statutes. The Application will be amended to reflect the “Statement of Applicant” will now be listed in what is now section 14 of the application.

Also, Section 775.082, Florida Statutes, is added to what is now section 14 of the application.

The language under “penalty of perjury” listed in section 15, the third (3rd) paragraph of the Application is amended and will be listed in what is now section 14 of the application, and will read:

I have carefully read the questions in the foregoing application and have answered them completely, without reservations of any kind, and I declare under penalty of perjury that my answers and all statements made by me herein are true and correct. Should I furnish any false information in this application, I hereby agree that such act shall constitute cause for denial, suspension, or revocation of my license to practice as an Electrologist in the State of Florida.

THE PERSON TO BE CONTACTED REGARDING THIS CHANGE IS: Allen Hall, Executive Director, Electrolysis Council, 4052 Bald Cypress Way, Bin #C05, Tallahassee, Florida 32399-3258