For the best experience and to prevent data errors, we recommend completing this form on a desktop or laptop computer, or tablet. One typo in your SSN or ORI number can cause a total rejection by the state.
Government Agencies DO NOT REFUND if you enter the wrong ORI number or apply for the wrong Agency. This form is strictly for Professional Licensing: All applicants seeking licensure or employment for Department of Health | AHCA | VR please use the appropriate application and exit.
The Agency Name is usually in your licensing info or our ORI search.
The fingerprint tech will meet exactly as preferred.
Convenience service for Medical Board applications.
Many medical licensing applications (especially for First-Time Applicants or Retiring Doctors) require a sworn affidavit to be notarized along with your fingerprints. Save a Trip: We can notarize these forms for you right now during your appointment.
Ensuring Your Results Link to Your Florida License
Before submitting this form, please open your official application with DBPR, AHCA, DOH, DCF, or your respective Florida agency. You must enter your name exactly as it appears on that application (including middle names, hyphens, and suffixes like Jr. or III).
CRITICAL: If you enter a different name on this form than what is listed on your licensing file, the state system will fail to link your fingerprints. This will cause your application to be SEVERELY DELAYED and may require a new fingerprint submission at your expense.
Required by the Florida Department of Law Enforcement and the FBI.
State & Federal Regulatory Compliance Notice
• Born in the USA: You must enter the specific State of birth (e.g., Florida). Do not enter "USA." • Born Outside USA: You must enter the specific Country of birth.
You must provide your current legal citizenship at the time of application. All physical descriptions (Height, Weight, Eye Color) are mandatory fields for biometric record matching.
These data points are strictly mandated by the FBI, FDLE, FINRA, ATF, and all Florida State Agencies (DBPR, AHCA, DOH, DCF). We do not collect information beyond what is required by these regulatory bodies to process your background clearance.
Great news: We can fingerprint two people at the same appointment.
Pursuant to Fla. Stat. § 435.04, all Level 2 Background Screenings for DBPR, DOH, AHCA, DCF, and other state regulatory bodies require verified identity data. Your Social Security Number (SSN) and official ID are mandatory to link your fingerprints to your specific professional license application.
The FDLE, DBPR, and DOH maintain a strict No-Refund Policy once data is submitted. If your SSN or personal data is incorrect, the state systems will reject the filing. This results in the immediate forfeiture of all state fees and requires a full repayment to re-apply.
Don't have your physical card? No problem. We accept these 3 alternatives for verification:
We accept all major credit cards securely.