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Every question on the application must be answered.
Fingerprints: all applications received must include electronically submitted fingerprints through a Livescan provider.
Where to send: Department of Health Certified Nursing Assistant Registry, 4052 Bald Cypress Way Bin# C-02, Tallahassee, FL 32399-3252.
Updates: the Board office must be notified in writing of anything which changes or affects a response given in your application.
Withdrawal: if you decide to withdraw your application, you must make the request in writing.
Review order: applications are reviewed in date order received.
| Question | Answer |
|---|---|
| Form Name | DH-MQA 5022 |
| Form Length | 15 pages |
| Application Type | CNA License Endorsement (Reciprocity) |
| Issuing Authority | Florida Board of Nursing, Department of Health |
| Background Check Required | Yes - Livescan Fingerprinting |
| Who Should File | CNAs with active certification from another state |
| Fillable? | No |
| Avg. time to fill out | 45 min |
| Edition | 06/18 |
| Other names | DH-MQA 5022, DH-MQA5022, MQA 5022, Certified Nursing Assistant Licensure by Endorsement Application |
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