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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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National Interest Waiver (NIW) Program

Contact the Florida Department of Health

  •  850-245-4009

    Mailing Location

    4052 Bald Cypress Way 

    Bin A-05 

    Tallahassee, FL 32304

The Physician National Interest Waiver is one step in the process for a foreign physician to obtain permanent resident status (green card) through the US Department of State (DOS) and the US Citizenship and Immigration Services (USCIS). You must obtain a statement from a federal agency or a state department of health that has knowledge of your qualifications as a physician and that states your work is in the public interest. In Florida, that sponsorship/recommendation is coordinated through the Primary Care Office (PCO).


Physician Eligibility

  1. The physician must practice clinical medicine.
  2. The physician must practice medicine full time - no less than 40 hours per week – for at least five (5) years (not counting any time in J-1 status).
  3. You must serve either in a Health Professional Shortage Area (HPSA), Mental Health- Health Professional Area (MH-HPSA – for psychiatrists only), a Medically Underserved Area (MUA), or a Veterans Affairs facility.
  4. Applicants must have a current Florida medical license.

Employer Eligibility

  1. All employers, facilities, and practice locations must be physically located in Florida.
  2. Employer practice locations must be in designated health professional shortage areas (HPSAs).

Employment Contract Eligibility

For an employment contract to be considered eligible, it must:

  1. Be signed by the head of the medical facility and the physician
  2. Dated
  3. Be a minimum five-year term of full-time employment, including the specific start and end dates
  4. Description of the patient demographics of the area served by the employer
  5. Obligate the physician to work at least 40 hours per week providing clinical medicine
  6. Specify the site in which the physician will work (if more than one, all sites must be listed)
  7. The HPSA identifier numbers, HPSA name, and score
  8. Include a clause that the contract can only be terminated for cause until completion of the five-year commitment, and
  9. Not contain a non-compete provision.

Submission Timeframes

Support letters may be requested year-round.

Process to Apply

Application packets can be emailed to or mailed to:

The Florida Department of Health
Division of Public Health Statistics and Performance Management
State Primary Care Office
4052 Bald Cypress Way Bin #A05
Tallahassee, Florida 32399-1720.

Documentation Required

  1. NIW Application for Letter of Support
  2. A Cover Letter from the employer, signed and dated by the medical facility director on the facility's letterhead. The letter should include:
    1. Name of the facility/employer
    2. The telephone number of the practice locations/facilities
    3. An email address of a contact at the facility
    4. the HPSA identifier number and HPSA name for all employment sites.
  3. Employment Contract
  4. Evidence that the facility is located in a designated shortage area (copy of the HRSA query result),
  5. Copy of the physician’s valid Florida medical license
  6. Curriculum Vitae of the physician
  7. Personal Statement from physician regarding his or her reasons for not wishing to fulfill the two-year home country residence requirement to which the applicant agreed at the time of acceptance of exchange visitor status
  8. Form G-28 (Notice of Entry of Appearance as Attorney or Accredited Representative) or letterhead from law office, if an attorney represents the applicant

After Application

After reviewing the submitted documents, if all of the requirements have been made, the Letter of Support will be drafted and emailed to the physician and their lawyer to include with their application filing for an NIW.

Sites receiving waiver approval must agree to report to DOH on the status of their NIW physician’s placement’s activities at the start of employment and every 12 months thereafter during the 5-year obligation service period, using the Florida NIW Physician Practice Status Report.

Contract Changes

Contract changes that result in a change of practice location or employer that require a support letter from the state health department must be presented in writing to the Department at least ten business days prior to the change.

Change in practice location – Notification of contract changes that result in the relocation of the physician from the employer’s current approved site(s) to a new site(s) must include:

  • the name and address of the new location(s),
  • the reason for the change, and
  • verification that the new site(s) are located within a designated shortage area.

Change in Employers – A transfer request must be made when a physician transfers from:

  • one Florida provider to another Florida provider
  • an out-of-state provider to a Florida provider, or
  • a Florida provider to an out-of-state provider.

Transfer requests must include:

  • A cover letter from the physician indicating the intent to transfer, reasons for the transfer, proof of the extenuating circumstance(s), and intended date of transfer
  • A letter from the current employer indicating the release of the physician and reasons for termination of employment. If the physician is unable to obtain a letter from the current employer due to the extenuating circumstance(s), the physician shall clearly state this in their letter and provide a detailed explanation as to why the letter cannot be obtained.
  • A letter from the new employer stating their desire to hire the physician.
  • Employment Contract from the new employer that incorporates all eligibility requirements [see Employment Contract Eligibility section above].
  • Evidence of Shortage Designation Status: A copy of the HRSA “Find Shortage Areas by Address” query result for each practice site location, and
  • Florida Medical License, if the physician is relocating into Florida.


In the event of a termination of employment, the employer and/or the employee must notify the Department in writing within five business days of the termination.


Violation of any of the employer eligibility criteria in Rule 64W-1.003 may result in denial of future requests for visa waivers.