Written Certification - By Mail with Check or Money Order

Important Information:

• Request for certification of licensure received without the appropriate fee will be returned unprocessed to the sender.
• The Division of Medical Quality Assurance cannot guarantee your certification will meet the deadlines for other State Boards. The current turn around time for certifications is approximately 4 to 6 weeks from receipt.  Please check your deadline dates  before you submit your certification request.
• Release forms from the licensees are not required for certifications.
• Exemptions: Financial information, medical information, school transcripts, examination questions, answers, papers, grades and grading keys, which are confidential and exempt forms. 119.07(1) 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).

Instructions for submitting a request via mail:

• Make check or money order payable to the Board/Council to be researched, in the amount of $25.00, for each individual certification requested. (You may also use a credit card to request the Certification.)
• Include name and address where certification is to be sent.
• Certification of Licensure order form
• Non-Licensure Certification order form

Mail your request and fee to:
Division of Medical Quality Assurance
Client Services Unit,   Office Box 6320
Tallahassee, FL 32314-6320