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Practice Agreement · RN

Registered Nurse Practice Agreement in Florida

Florida law does not require a Registered Nurse to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.

Practice authorityIndependent practice
Written agreementNo agreement required
What Florida calls itNo instrument required
Governing boardFlorida Board of Nursing
Research date2026-08-14 · clauses 2026-09-03

FULL for general nursing scope (§464.003(19)) — the LPN definition explicitly requires practice 'under the direction of' a supervisor, language conspicuously absent from the RN definition. Physician-delegated medical-aesthetic procedures (Botox, fillers) are a narrower, genuinely unsettled carve-out — the one confirmed-real precedent (a 2017 Board of Nursing declaratory statement) reportedly denied RN injection authority; see agreementRequiredNote below.

What a Registered Nurse practice agreement covers in Florida

Governed by the Florida Board of Nursing. Each numbered item is a statutory requirement the agreement must satisfy.

  1. The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician, consistent with the scope of practice recognized by the Florida Board of Nursing under Section 464.003, Florida Statutes. Unlike the written protocols required of Advanced Practice Registered Nurses and Physician Assistants, Florida law does not require a Board-filed protocol for Registered Nurses; the Physician shall instead be available to the Registered Nurse for consultation regarding clinical and patient care issues arising under any order or delegation.

  2. The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.

Statutes and rules cited

  1. Section 465.1865, Florida Statutesstatute

    Collaborative pharmacy practice for chronic health conditions -- certification, required agreement contents, Board filing, and professional liability insurance requirements.

  2. Section 458.347, Florida Statutesstatute

    Caps the number of Physician Assistants a supervising physician may supervise at one time (raised from four to ten by 2021 c. 2021-118, Laws of Fla.).

Terms it has to carry

Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.

Proximity

physician-delegated Botox/dermal-filler injection (outside general RN scope — see agreementRequiredNote on the unsettled regulatory basis): On-site presence required

Coded as ON_SITE reflecting the model industry practice actually uses (direct physical-presence physician supervision with visualization of the injection, physician being MD/DO under Ch. 458/459 rather than an APRN) — NOT because a specific codified or reliably-verified precedent was confirmed to require it. The main citation previously used for this ('Cremeans,' DOH-24-0637) could not be verified and should not be relied on; see agreementRequiredNote above for the full caveat and the one confirmed-real (but unfavorable) 2017 precedent.

Supervision ratio

Not codified — no cap on file

Chart review

Not codified — left to the agreement

Meeting cadence

Not codified — left to the agreement

Prescriptive authority

Covered by the practice agreement · no controlled-substance authority

General RNs (non-APRN) have no independent prescriptive authority under any provision reviewed — §464.003(19) frames medication administration as 'as prescribed or authorized' by a licensed practitioner, never RN-originated.

Written agreement

Not required

Unconditional for general nursing practice — no protocol/agreement required. The regulatory basis for physician-delegated medical-aesthetic procedures (Botox/filler) is genuinely unsettled: a widely-cited Board of Nursing declaratory statement ('Cremeans,' Final Order No. DOH-24-0637, May 2024) COULD NOT be verified in two independent research passes (broken DOH archive, zero hits on flrules.org/DOH search, and absent from an industry article that otherwise catalogs every real declaratory statement in this space back to 2015) — treat that specific citation as unreliable. The one confirmed-real precedent found, a 2017 declaratory statement (Final Order No. DOH-17-1797-DS-MQA), reportedly DENIED an RN's authority to inject Botox absent proper physician delegation — cutting against easy permissibility, though its exact current holding wasn't independently re-verified here either. Industry practice commonly proceeds via direct-physician-supervision delegation regardless, but the codified/precedential basis for that practice is not solidly confirmed as of this research pass — verify directly (e.g., a DOH records request) before relying on this for a compliance decision.

Practice ownership (corporate practice of medicine)

Non-licensee ownership permitted — RNs, estheticians, and non-clinical investors may hold ownership in a Florida med-spa LLC (secondary-source consensus; no CPOM doctrine in Florida) — but an RN owner cannot serve as medical director or perform physician-delegated procedures based on ownership alone.

For medical-aesthetics businesses, the common structure (secondary-sourced) pairs RN/non-clinical ownership of the business side with an independent-contractor physician medical director for the delegated-procedure side.

Legal sources for these rules (5)

About Florida's rules

Florida's 2020 autonomous-practice law (§464.0123, ≥3,000 supervised hours + coursework) creates a real independence pathway for NP and CNM — but excludes PMHNP, CRNA, and CNS entirely; CRNA autonomy bills have died three sessions running (2024-2026). Florida has no corporate-practice-of-medicine doctrine (secondary-source consensus) — entity ownership instead turns on the Health Care Clinic Act's §400.9905 exemption mechanics. Supervision ratio/chart-review/meeting-cadence are largely uncodified; PA's 10-supervisee cap is the exception.

Other clinicians in Florida: see the state overview.