DH-MQA 5022 PDF Details

Florida requires verification of an active license in another state.

Examination: if you do not hold an active CNA license in another state, you would need to apply to take the examination through Prometric.

Fingerprints: all applicants, including out-of-state applicants, are required to submit their fingerprints electronically.

ORI number: the ORI number for the Board of Nursing is EDOH0380Z.

Verification: if unavailable online or if the online verification lacks sufficient detail, you will be required to request an official verification.

Signature: you may print this application and sign it or sign digitally.

Incomplete application: an incomplete application shall expire one year after the initial filing with the department.

QuestionAnswer
Form NameDH-MQA 5022
Form Length14 pages
Application TypeCNA License Endorsement (Reciprocity)
Issuing AuthorityFlorida Board of Nursing, Department of Health
Background Check RequiredYes - Livescan Fingerprinting
Who Should FileCNAs with active certification from another state
Fillable?Yes
Avg. time to fill out37 min
EditionRevised 6/2020
Other namesDH-MQA 5022, DH-MQA5022, MQA 5022, Certified Nursing Assistant Licensure by Endorsement Application

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