(1) A health care provider shall not refer a patient to an entity in which such provider is an investor unless, prior to the referral, the provider furnishes the patient with a written disclosure form, informing the patient of:
(a) The existence of the investment interest.
(b) The name and address of each applicable entity in which the referring health care provider is an investor.
(c) The patient’s right to obtain the items or services for which the patient has been referred at the location or from the provider or supplier of the patient’s choice, including the entity in which the referring provider is an investor.
(d) The names and addresses of at least two alternative sources of such items or services available to the patient.
(2) The physician or health care provider shall post a copy of the disclosure forms in a conspicuous public place in his or her office.
(3) A violation of this section shall constitute a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083. In addition to any other penalties or remedies provided, a violation of this section shall be grounds for disciplinary action by the respective board.