Licensure Certification Form

Licensure Certification Form

If you are requesting certification of a state license, please complete and submit the online request form or you can print and mail your request and required fee for processing to:

Division of Medical Quality Assurance
Licensure Support Services
Attn: License Verifications
P.O. Box 6320
Tallahassee, FL 32314-6320
 

Important Information

  • Please use this form to request certification of your Florida license by mail.
  • Please allow 7 to 10 days for your request to be processed.
  • If you need to verify a license that you hold in another state, please contact your state board.
  • If you are applying for a Florida license, you do not need to submit a verification request for your Florida license.
  • If you are requesting that your exam scores be submitted with your request for certification, please complete and forward the attached Waiver of Confidentiality and Authorization to Release Scores Form with your request for certification. Please be aware that most states do not require exam scores, please check with the licensing authority prior to requesting this information.
  • Do Not Use This Form for License Renewal. If you are trying to renew your license, click here.
 

For EMTs, Paramedics, and Radiologic Technologists

There is no fee associated with Licensure Verification for your profession.
Complete the License Certification form and mail to:

Department of Health
Licensing Support Services
4052 Bald Cypress Way
Bin C-10
Tallahassee, Florida 32399-3260
 

For All Other Health Care Professions

You may request licensure certification online or in writing. Include a cashier's check or money order, payable to the Department of Health, in the amount of $25.00 for each certification requested.

 

Other Important Information

Requests for licensure certification received without the appropriate fee will not be processed and a new request with fee will be required to complete the process.

The Division of Medical Quality Assurance cannot guarantee your verification will meet the deadlines for other State Boards. The current processing time for licensure verifications is approximately 10 days from receipt. Please check your deadline dates before you submit your verification request.

Release forms from the licensees are not required for verifications.

Exemptions: Financial information, medical information, school transcripts, examination questions, answers, papers, grades and grading keys, are confidential and exempt forms pursuant to Chapter 119.071, Florida Statutes and will be withheld pursuant to Chapter 456.057, Florida Statutes. Social Security numbers will also be redacted pursuant to 42 U.S.C. 405(c)(2)(C) (vii)(1).

 
Other Links





Human Trafficking Procedures

Human Trafficking

Florida passed Human Trafficking, Chapter 2019-152, Laws of Florida, which establishes new profession requirements including newly required signs, CE/CME, and more for the following professions: Acupuncture, Medicine, Osteopathic Medicine, Chiropractic Medicine, Podiatric Medicine, Optometry, Pharmacy, Dentistry, Nursing Home Administration, Occupational Therapy, Dietetics and Nutrition, Respiratory Care, Massage Therapy, and Physical Therapy.

The Department has launched an informational website that includes a breakdown of the new law and addresses areas of: (1) signs; (2) CE/CME; (3) FAQs; (4) Specific Board of Massage requirements; and (5) Human Trafficking Reporting.

For more information please visit: www.flhealthsource.gov/humantrafficking/

HB 451

Nonopioid Alternatives Pamphlet

2020 legislation amended the requirements related to providing the non-opioid alternatives pamphlet to patients. Click here for information and access to the pamphlet.

743: Nonopioid Alternatives
Effective Date: July 1, 2020

http://www.flsenate.gov/Session/Bill/2020/743/BillText/er/PDF

The bill revises the requirements for certain health care practitioners providing an opioid drug listed as a Schedule II controlled substance to inform the patient about possible nonopioid alternatives, discuss the advantages and disadvantages of nonopioid alternatives, and provide the pamphlet as required in section 456.44, Florida Statutes by:

  • Requiring that the pamphlet provided to the patient be printed;
  • Authorizing a health care practitioner to discuss non-opioid alternatives with, and provide the pamphlet to, the patient’s representative rather than the patient;
  • Specifying that only those health care practitioners ordering or prescribing or providing care that requires the administration of anesthesia using an opioid must meet the requirements and removing the requirement to address non-opioid alternatives when a drug is dispensed or administered; and
  • Exempting health care practitioners providing hospice services and providing care in a hospital critical care unit or emergency department from the requirement to discuss non-opioid alternatives with a patient or the patient’s representative and provide a printed copy of the pamphlet.

Credential Hotline

Credential Verification Hotline Banner

Volunteer Credentialing Hotline: 1-844-CALLDOH (225-5364)

Posted on: September 8th, 2017

Health Care Practitioners around the country have responded to the emergency situation in Florida created by Hurricane Irma. Hospitals that may have staffing difficulties due to the emergency have expressed interest in having these practitioners made available to them. The Department of Health offers its assistance in verifying credentials of these volunteers. Once verified, the department can assist in the registration of the volunteer in accordance with Governor Rick Scott’s Executive Order declaring a state of emergency re: Hurricane Irma # 2017-235.

To request verification, please contact the department at 1-844-CALLDOH (225-5364).Have ready the volunteer’s full name, license number, name of the jurisdiction in which they are licensed, and SSN. We recommend that you keep a photocopy or electronic copy of these documents and a copy of the volunteer's photo identification.