UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 5
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
( ) Check box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. See Instructions 1(b).
( ) Form 3 Holdings Reported
( ) Form 4 Transactions Reported
1. Name and Address of Reporting Person
Hardy, A. Thomas
c/o 2555 Davie Road, Suite 110
Fort Lauderdale, FL 33317
USA
2. Issuer Name and Ticker or Trading Symbol
ProxyMed, Inc.
PILL
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
12/31/2001
5. If Amendment, Date of Original (Month/Year)
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other
(specify below)
Senior Vice Pres., Laboratory Services
7. Individual or Joint/Group Reporting (Check Applicable Line)
(X) Form filed by One Reporting Person
( ) Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect |
|Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership |
|Date |Code| | Beneficially |(D)or | |
| | | | A/| | Owned at |Indir | |
| | | Amount | D | Price | End of Year |ect(I)| |
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Common Stock, $.001 par value|8/15/0|C |7,500* |A |** |48,642 |D | |
|1 | | | | | | | |
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Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned |
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1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of|
Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect |
|or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial |
|cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership |
|ice of | | | posed of(D) |Day/Year) | |rity |Benefi |or | |
|Deriva | | | |Date |Expir| | |ficially |Ind| |
|tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| |
|Secu | | | | D |cisa-|Date | of Shares | |End of |ct | |
|rity | | | Amount | |ble | | | |Year |(I)| |
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Warrants |$15.00* |8/15/|C |** 10,000* |A,D| |6/28/|Common stock|10,000*|** |51,091 |D | |
| |01 | | | | |05 | | | | | | |
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Explanation of Responses:
*Adjusted to reflect the 1-for-15 reverse stock split on August 21,
2001.
**Warrants exchanged pursuant to the terms and conditions of the Issuer's
exchange offering as reported to the
SEC by the Issuer on Form 8-K filed on June 15, 2002 and August 21,
2001.
SIGNATURE OF REPORTING PERSON
A. Thomas Hardy
DATE
February 13, 2002