Conrad 30

Physician Eligibility

1. Physicians must currently reside in the U.S. and agree to reside in Florida and only treat patients in Florida for the duration of their approved Conrad 30 employment.
2. Physicians must have a U.S. Department of State case number at the time of application. Do not send any money to the Department. Any funds due to the U.S. Department of State for the J-1 Visa Waiver must be sent to them directly.
3. Physicians must have only applied for a Conrad 30 Program sponsorship from the Florida Department of Health.
4. Physicians must have a current, unrestricted Florida medical license (MD/DO), that is effective on or before the last date of the application period. License should be in clear active status. Registrations, including Resident Physician, Graduate Assistant Physician, Intern, Fellow, and House Physician are not eligible.
5. Physicians who are eligible to apply through the HHS Exchange Visitor Program are not eligible for the Florida Conrad 30 program.

Employer Eligibility

1. The sponsoring facility/employer and all practice site locations must meet one of the following:
   • Be a free clinic as defined in section 766.1115(3)(d)14., Florida Statutes,
   • Receive 100% of their funding by state or local government funds, without charging patients or their families, or
   • Accept Florida Medicaid clients and be actively billing Florida Medicaid, whether through Fee-For-Service or as a Medicaid Managed Care Plan provider.
2. All physicians at the practice site location must accept Medicaid. The applicant physician cannot be the only physician in the practice accepting Medicaid.
3. All employers, facilities, and practice locations must be physically located in Florida.

Employment Contract Eligibility

The following are required for an employment contract to be considered eligible:

1. Signatures of both the physician and employer.
2. Date the document was signed, either next to the signature or under it.
3. All practice locations must be clearly delineated, including the physical address. Any language that states the practice location can be changed or locations added at a future date shall make the contract ineligible
4. A statement that the physician will practice a minimum of 40 hours per week of direct patient care (in-person, face-to-face care with patients). Any language that alters the weekly 40 hours of direct patient care shall make the contract ineligible. Any mention of shift work will require a detailed explanation on how the 40 hours of direct patient care will be provided. Administrative duties, telemedicine, and being “available to provide direct patient care” may not be included in the 40 hours.
5. A minimum three-year term of full-time employment, including the specific start and end dates.
6. The statement that “full-time employment shall commence within 90 days after the waiver is approved by U.S. Citizenship and Immigration Services (USCIS)”. Any language that adds caveats to this statement shall make the contract ineligible.
7. A clause stating that the Florida Department of Health’s Primary Care Office will be notified in writing at least 60 days prior to the termination of the contract by either party or immediately upon termination if an immediate termination occurs.
8. There shall not be any non-compete clauses/provisions. Any language that looks to limit a physician’s ability to practice medicine after leaving the employer constitutes a non-compete provision, regardless of how the contract lists the restriction.
9. Termination of employment provisions shall provide that termination is only for cause. This is for both the employer and physician employee.
10. If the offer of employment letter includes provisions that are legally binding, it is part of the contract, and must be included with any contract and addendums. It must not be used as the Practice Facility Cover Letter, and if there are conflicting statements between them, an addendum should be done to clarify which language takes precedence; and
11. Any addendum or attachment that alters the original terms of the contract must also be signed and dated by both the physician and the employer as described in (1) and (2) above.

An example of how contract eligibility criteria #5 and #6 may be combined that still meets the requirements would be: “Full-time employment shall commence within 90 days after the waiver is approved by U.S. Citizenship and Immigration Services (USCIS), or July 1, 2023, whichever comes first, Employment will be for three years, ending on June 30, 2026.”

If the submitted employment contract is missing any of these requirements, a contract addendum will be required that adds the missing elements.

If the submitted contract includes non-compete provisions and/or termination without cause provisions, an addendum will be required that removes those provisions from the contract. The addendum can cover both additions and deletions – one addendum for each is not required.

Application packages, as outlined in Rule 64W-1.004, F.A.C., will be accepted beginning at midnight (EDT) on October 1st and must be received no later than 11: 59 p.m. (EDT) on October 31.

Process to Apply

Application packets must be uploaded to the Department’s FTP server. Please contact the Primary Care Office at FL.PCO@flhealth.gov well in advance to receive your login credentials, as October 31 does not always fall on a workday.

The following documents must be submitted to the Department to be evaluated for sponsorship:

1. Completed Conrad 30 Waiver Program: Florida DOH Sponsorship Application (DH8006-PHSPM-04/2026)
2. Physician Agreement (DH8007-PHSPM-04/2026)
3. Physician Attestation of Exclusivity (DH8008-PHSPM-04/2026)
4. Employer Practice Location Attestation – one attestation for each practice location (DH8009-PHSPM-04/2026)
5. Specialist Addendum
   Required if the physician is a specialist as defined in Rule 64W-1.002(9). Be sure to read and answer the questions. Failure to answer the questions correctly will make the application ineligible. (DH8010-PHSPM-07/2021)
6. Flex Addendum
   Required if any practice site is not located in a HPSA. Be sure to read and answer the questions. Failure to answer the questions correctly will make the application ineligible. (DH8011-PHSPM-07/2021)
7. Practice Facility Cover Letter
   Letter from the facility to the PCO/USDOS/USCIS explaining why the applicant physician is needed.
8. Copy of the employment contract and all addenda
9. Evidence of Shortage Designation Status
   Copy of the Health Resources and Health Administration (HRSA) “Find Shortage Areas by Address” query result for each practice site location.
10. Copy of your unrestricted clear, active Florida license as an allopathic physician under chapter 458, Florida Statutes, or as an osteopathic physician under chapter 459, Florida Statutes, that is effective on or before October 31. Registrations, including Resident Physician, Graduate Assistant Physician, Intern, Fellow, and House Physician are not eligible.
11. Physician curriculum vitae
12. Copy of USDOS Form DS-3035
    You must include copies of all bar code pages, supplemental pages, and the statement of reason as received back from the submission to USDOS.
13. Copy of all applicable USDOS Form DS-2019/IAP-66 received from the USDOS
14. Copy of USDOS Form G28 as submitted with USDOS Form DS-3035

Additional Documentation Requirements

• Every field of the Florida Conrad 30 Waiver Program Application must be completed. The Department will only accept applications submitted on the current application form.
• Be sure that all the forms submitted are the newest version. Only the Specialist Addendum and Flex Addendum were not updated in 2026.

At the close of the application cycle, Department staff will conduct an initial review of the information contained in the application packet. Any application deemed ineligible during the initial review by the Department based on any failure in paragraphs (a) through (d) below will not be recommended to the State Surgeon General (or designee) for sponsorship.

An application package will be deemed ineligible if:

1. It does not meet the eligibility requirements in rule.
2. It does not include all application requirements in rule.
3. It is submitted by any method other than what is listed in Process to Apply section above.
4. Is not received within the timeframes stipulated in rule.

Correspondence and/or communication between employers, physicians, or attorneys with Department staff will not take place during the initial review and prioritization of applications.

After final approval by the State Surgeon General (or designee), Department staff will notify each applicant on his or her sponsorship status by email. This shall occur on or before January 31, of each year, unless the conditions below occurs. The Department will send sponsorship application packets to the USDOS, on or before January 31, of each year, unless the conditions below occurs.

In the event the total number of applications deemed eligible by the Department during the initial review is fewer than 30 for sponsorship, applications received during the application cycle that were deemed ineligible will be notified by email of the deficits in their application package.

• All additional documentation must be received on or before 10 business days, excluding state holidays or office closures, from the date of the Department’s deficiency notice. All updated applications will be evaluated based on the scoring priorities stipulated in 64W-1.005, F.A.C., in order to bring the total number sponsored to 30.
• All applicants whose application was deemed eligible during the initial review will be notified of their sponsorship on the same day that the deficiency notices are sent. A copy of the sponsorship letter will not be sent until after the deficient applications have been reviewed and the remaining slots have been filled.

In the event the total number of sponsorships is fewer than 30 after the October application period, the Department may open a second application period. Whether there will be a second application period or not, and the exact dates and number of spots to be filled if there is a second application period, will be published above no later than March 15.

If there is a second application cycle, the following process will be followed:

1. All eligibility requirements, as provided in Rule 64W-1.003, F.A.C., must be met.
2. Applicants will be limited to those applying for the first time and those eligible physicians who applied in the first application cycle but were unable to fix their deficiencies within the allowable time.
3. Complete applications must be submitted during the second application cycle.
4. Only one (1) application per person will be reviewed, and it will be the first one submitted. There will not be an opportunity to correct the application once submitted.
5. Applications will be reviewed on a first-come, first-served basis.
6. The sponsorship priorities in Rule 64W-1.005, F.A.C., will apply.
7. Once the number of sponsored applications reaches 30, the second application cycle will be closed. The closure will be published above as soon as the total sponsored applications reaches 30.
8. All applicants will be notified by email of their final disposition.

The Department will sponsor applicants based on these priorities:

1. The Department will sponsor applicants based on the following priorities, in order:
   • (a) Primary care physicians
     1. HPSA score (high to low), then by
     2. Rural counties, as defined in section 381.0406, Florida Statutes, then by
     3. Percent of total practice of patients on Medicaid (high to low), then by
     4. Percent of total practice of patients utilizing the practice’s sliding fee scale (high to low), and then by
     5. Ambulatory outpatient care practices, then safety net hospitals and critical access hospitals, followed by all other types of inpatient care facilities.HPSA score (high to low), then by
   • (b) Specialty Physician
     1. HPSA score (high to low), then by
     2. Rural counties, as defined in section 381.0406, Florida Statutes, then by
     3.  Percent of total practice of patients on Medicaid (high to low), then by
     4. Percent of total practice of patients utilizing the practice’s sliding fee scale (high to low), and then by
     5. Ambulatory outpatient care practices, then safety net hospitals and critical access hospitals, followed by all other types of inpatient care facilities
2. If there are applications that have equal priorities for the last available slot(s), the application(s) will be re-evaluated based on the aforementioned priorities. If there are still applications that are equal, the State Surgeon General, or designee, will select the final applicant(s).
3. If the State Surgeon General determines that there is a critical shortage, Department staff will forward to the State Surgeon General (or their designee) all applications deemed complete for the specified specialty and/or in the specified geographic location, for the State Surgeon General’s (or designee’s) determination of sponsorship. These applications will take precedent, superseding all other priority criteria, with the remainder of the available slots being filled based on the priority criteria listed in (1).

1.   The physician and employer must complete, and the physician must submit to the Department the Conrad 30 Waiver Program Practice Status Report (DH8012-PHSPM-04/2026), on or before June 30 of each year during the employment period. A USCIS Notice of Action form, including the Informational pages, should be included with each submission.

2.   If a Practice Status Report is not received annually, the physician will not receive a completion letter from the Primary Care Office Director.

3.   If the information in the Practice Status Report does not match the information in the initial application and any subsequent changes supported by the Department and approved by USCIS, the physician will not receive a completion letter.

Contract changes that result in a change of practice scope, location, or employer must be presented in writing to the Department at least 10 business days prior to the change.

The change in scope must be clearly explained in a cover letter and follow all eligibility criteria in Rule 64W-1.003, F.A.C.

Contract changes that result in a change of practice scope, location, or employer must be presented in writing to the Department at least 10 business days prior to the change.

When there are contract changes that result in the relocation of the physician from the employer’s current approved site(s) to a new site(s) or adding practice locations, the employer must notify the PCO in writing and must include:

• Name and address of the additional/new location(s)
• Reason for the change
• Verification that the new site(s) are located within a designated shortage area.
  If the new site(s) are not located in a designated shortage area, then a Flex Addendum is required to be submitted to the PCO director.

Contract changes that result in a change of practice scope, location, or employer must be presented in writing to the Department at least 10 business days prior to the change.

Transfer request must be made when a physician transfers from:

• One Florida employer to another Florida employer
• Out-of-state employer to a Florida employer
• Florida employer to an out-of-state employer

Transfer requests must include

• Cover letter from the physician indicating the intent to transfer, reasons for the transfer, proof of the extenuating circumstance(s), intended date of transfer, and intent to continue upholding all requirements of Rule 64W-1 F.A.C.
• 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.
• Letter from the new employer stating their desire to hire the physician.
• Physician Agreement (DH8007-PHSPM-04/2026).
• Physician Attestation of Exclusivity (DH8008-PHSPM-04/2026).
• Employer Practice Location Attestation– one per practice location (DH8009-PHSPM-04/2026)
• Specialist addendum (DH8010-PHSPM-07/2021), if the physician is not a primary care physician as defined in the rule.
• FLEX Addendum (DH8011-PHSPM-07/2021), if any practice site is not located in a HPSA.
• Employment Contract from the new employer that incorporates all eligibility requirements in Rule 64W-1.003(3), [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

If the physician is moving into Florida with an approved J-1 Visa Waiver, the following should also be submitted:

• Proof of an unrestricted clear, active Florida license as an allopathic physician under chapter 458, F.S., or as an osteopathic physician under chapter 459, F.S., that is effective prior to the physician beginning employment with the new employer. Registrations, including Resident Physician, Graduate Assistant Physician, Intern, Fellow, and House Physician are not eligible.
• Completed Conrad 30 Waiver Program Florida DOH Sponsorship Application (DH8006-PHSPM-04/2026)
• Written documentation (letter or email) from the primary care office the physician is transferring from, acknowledging that the physician is relocating.

A USCIS Notice of Action form, including the Informational pages, should be submitted to the Primary Care Office within ten (10) days of receipt for any change in location or employer.

In the event the current employer’s business changes ownership and the Conrad 30 physician’s practice location does not change, a modified list of transfer documents is required, and include:

• Letter from the current employer acknowledging the change in ownership and the anticipated date of change.
• Letter from the new owner stating their desire to continue the employment of the physician.
• Employer Practice Location Attestation – one per practice location (DH8009-PHSPM-04/2026).
• Employment Contract from the new employer that incorporates all eligibility requirements in Rule 64W-1.003(3) [see Employment Contract Eligibility section above].

If the change in ownership also changes the Conrad 30 physician’s practice locations, the letter from the new owner should include:

• Name and address of the additional/new location(s)
• Reason for the change
• Verification that the new site(s) are located within a designated shortage area
  If the new site(s) are not located in a designated shortage area, then a Flex Addendum is required to be submitted to the PCO director.

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, F.A.C. may result in denial of future requests for visa waivers.