Florida requires that a caregiver referred by a nurse registry provide documentation that they are free from communicable disease before being referred for client care.
On the surface, that sounds simple. In practice, it is confusing, inconsistent, expensive, and stressful for everyone involved.
The problem inside a working registry
Abby Services, a Florida-licensed nurse registry in Fort Myers, ran into the same issue over and over.
Caregivers were spending real money at urgent care centers, walk-in clinics, and physician offices trying to obtain the required documentation — commonly $75 to $150, sometimes more, paid out of pocket before earning a first referral.
And often they came back without it. Physicians were understandably reluctant to sign a broad statement declaring someone "free from communicable disease," even after an examination and testing. That reluctance was reasonable. No examination can establish that a person is free from every communicable disease, and providers know it.
Why the registry didn't want to solve it in-house
The obvious fix — the registry handling the screening itself, or issuing its own form — created a different problem.
Under the Florida nurse registry model, caregivers are independent contractors. The more a registry directs, controls, or administers onboarding processes, the harder that distinction is to maintain. Even issuing a prepopulated form for a physician to complete began to look like directing how a caregiver satisfied a requirement.
A registry providing a form is not trying to control anything. But appearances can carry weight in an evaluation of whether a caregiver is a contractor or an employee, and rather than defend the distinction, the registry chose to remove the question entirely.
That left everyone stuck in the same place:
- Caregivers needed affordable documentation
- Registries needed compliant records
- Physicians did not want to sign broad statements
- And no registry wanted to run the process itself
Looking at how the question has been answered elsewhere
Rather than invent something, the founder of MyHealthForm.com went looking for how other healthcare organizations already handled communicable disease screening.
Structured screening instruments turned out to be common. The Wisconsin Department of Health Services publishes a standardized Communicable Disease / Tuberculosis Screening Questionnaire through its official state forms library. The Mount Sinai Health System publishes an Infectious Diseases Screening Tool used in its own occupational health program.
Both focus on the same things: current symptoms, exposure history, tuberculosis risk factors, and practical communicable disease indicators — the questions a clinician would actually ask.
Those instruments became the basis for the MyHealthForm.com screening.
What we asked the state, and what came back
Before building anything, the direct route was tried first.
AHCA was approached for clarification on how the requirement should be satisfied. The agency's position was that it simply enforces this requirement rather than writes it — the language originates in statute, and amending it would take action by the Florida Legislature, which is no small task. The Department of Health was also approached separately, seeking a working definition of "communicable disease" for this purpose or an acceptable screening instrument.
Neither produced an approval, a definition, or a published instrument. AHCA does not issue written determinations approving screening tools or services, and no such definition or instrument has been published.
That is worth stating plainly, because it applies to everyone: no vendor holds AHCA approval for a communicable disease screening, because no such approval is issued to anyone. More on that here.
What was built
The result was a written protocol, established and signed by a licensed physician, under which a Florida-licensed Registered Nurse reviews a structured screening and issues the health statement when the responses meet the criteria — or withholds it and directs the caregiver to a provider when they don't.
That process ran inside a working registry beginning in 2007, through more than a hundred screenings, before it became a service anyone else could use.
The goal was never to create a shortcut. It was to build something that was:
- Affordable and fast for caregivers
- Something a physician could reasonably stand behind
- Operationally clean for registries
- Rooted directly in the wording of the statute
Where it stands
What started as an operational frustration inside one Fort Myers nurse registry became a service now used by caregivers and registries across Florida.
Sometimes the best ideas aren't born in boardrooms. Sometimes they come from trying to solve a real problem the right way.
MyHealthForm.com is a separate business from Abby Services, Inc., though both were founded by the same Registered Nurse. No registry is required to use this service, and registries remain free to accept qualifying documentation from any appropriate healthcare professional.