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It's a New Day in Public Health.

The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county, & community efforts.

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Request for Disciplinary and Licensure Documents


Request for Disciplinary and Licensure Documents

Fees and Charges

  • $.00 for 50 pages or less

  • $.15 per page for the total number of pages if the number exceeds 50 pages (e.g., if the documents equal 52 pages, requestor is charged for 52 pages, not 2 pages)

  • Microfiche - $.62 per page for the total number of pages if the number exceeds 15 pages (e.g., if documents equal 16 pages, requestor is charged for 16 pages, not 1 page)

  • Certification of documents $25.00 each

  • Research time is charged when in excess of 30 minutes and is based on the salary level of the lowest paid employee able to perform the research.



  • I would like certified copies. ($25.00 fee - written statement on a public record attesting to the record's genuineness or that it is a true and correct copy)



    Licensee First Name or Business Name:


    Licensee Last Name:


    Licensee License Number:


    Licensee Profession:


    Document Type (check all that apply)







    Additional identifying information (address, school, etc.) or special instructions to processor. Limit of 4 lines.



    Please enter requestor information below:

    Requestor Name:


    Company:


    Email:


    Telephone:


    Extension:


    Fax:


    Street Number:


    Street Name:


    Street Address Line 2:


    City:


    State:


    Zip Code


    (Note:Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.)

     

    Please mail documents to:
     


    Use Requestor Address?



    Contact Name:


    Company:


    Email:


    Telephone:


    Street Number:


    Street Name:


    Address Line 2:


    City:


    State:


    Zip: