Licensed Clinical Social Worker

To be licensed as a Clinical Social Worker in Florida you must have the documents listed below. Endorsement applicants only need items 5 through 9. Registered Interns applying for full licensure need items 4 and 6-9.

1. OFFICIAL TRANSCRIPT: A master’s degree in social work from a Council on Social Work Education (CSWE) accredited school of social work showing graduate level coursework. Ensure your program is accredited by visiting https://cswe.org.

NOTE: Electronic Transcripts may be sent through a secure parchment service directly to MQA.491@flhealth.gov. Please check with your university to see if this service is available.

Mailed transcripts must be sent in a sealed envelope from the university or they will not be considered official. A degree conferred date must be listed on the transcript. This is the only document that CANNOT be uploaded in your online account. Official transcripts may be mailed to:

Florida Department of Health
Board of CSW, MFT, and MHC
4052 Bald Cypress Way
Bin C-08
Tallahassee, FL 32399-3258

COURSEWORK:

Completed 24 semester hours or 32 quarter hours in theory of human behavior and practice methods as courses in clinically oriented services, including a minimum of one course in psychopathology. Courses not considered to be clinically oriented are: policy, administration, organization and communities. Complete the Education Worksheet for clinical social work to determine if you have satisfied the coursework requirements for licensure.

FOREIGN EDUCATION:

If you received your social work degree from a program outside the U.S. or Canada, documentation must be received that the program was determined to be equivalent to programs approved by the Council on Social Work Education by the International Social Work Degree Recognition and Evaluation Service provided by the Office of Social Work Accreditation (OSWA), and a course by course evaluation must be completed by a Board approved evaluator. To contact the OSWA, please visit https://cswe.org or call (703) 683-8080. For a list of approved Foreign Education Evaluators, please click here.

2. PRACTICUM: A supervised field placement that was part of the applicant’s master’s program, during which the applicant provided clinical services directly to clients. An official of the school (Dean, Department Chair) that awarded your graduate degree must provide a letter on university letterhead verifying that the supervised practicum, internship, or field experience was completed, during which the applicant provided clinical services directly to clients. Please review the specific requirements on the Education Worksheet for clinical social work.

3. ADVANCED STANDING LETTER: If you are an advanced standing student, you may need to request an advanced standing letter from the school of social work listing the courses completed at the bachelor’s level that were not required at the master’s level. Review the Education Worksheet for clinical social work to determine if the coursework requirements for licensure have been satisfied. The letter must include the course title and number of credit hours completed.

4. SUPERVISED EXPERIENCE: Two (2) years of post-master’s supervised experience under the supervision of a licensed clinical social worker. These hours must be documented on the Verification of Clinical Experience Form or they will not count towards licensure. The supervision experience must have consisted of:

• At least 100 hours of supervision in no less than 100 weeks;
• 1,500 hours of face-to-face psychotherapy with clients; and,
• 1 hour of supervision every two weeks

NOTE: Please see Rule 64B4-2.002, F.A.C. for information regarding group supervision and supervision by electronic methods.

5. LICENSE VERIFICATION: This form is required for applicants who hold or have ever held a license in another state, U.S. territory, or foreign country. Please have the office that issued the license or certification complete the Florida Certification/License Verification Form. A license verification is required for all endorsement applicants. The document must show your license type, date issued, current status and discipline history.

6. EXAM: Passed the national clinical level examination developed by the Association of Social Work Boards (ASWB). For information about the exam required, click here.

Note: Beginning January 1, 2023, exam approvals will only be issued to those who have completed a minimum of 18 months of post-master’s clinical experience.

7. LAWS & RULES COURSE: Completed an 8-hour Florida laws and rules course from a board approved provider listed on CE Broker.

8. HIV/AIDS COURSE: Completed a 3-hour HIV/AIDS course listed on CE Broker or complete the HIV/AIDs Affidavit.

9. DOMESTIC VIOLENCE COURSE: Completed a 2-hour domestic violence course from a board approved provider listed on CE Broker within six months of licensure. The certificate of completion is retained with your records. Do not submit to the Board Office with your application.

Applicants with Health History

If a “Yes” response was provided to any of the questions in this section, provide the following documents directly to the board office:

A letter from a licensed health care practitioner, who is qualified by skill and training to address the condition identified, which explains the impact the condition may have on the ability to practice the profession with reasonable skill and safety. The letter must specify that the applicant is safe to practice the profession without restrictions or specifically indicate the restrictions that are necessary. Documentation provided must be dated within one year of the application date.

A written self-explanation, identifying the medical condition(s) or occurrence(s); and current status.

Applicants with Discipline History

Applicants with prior disciplinary actions are required to submit the following:

Board Actions – Certified copies of document(s) relative to any disciplinary action taken against any license. The documents must come from the agency that took the disciplinary action and must be certified by that agency.

Self-Explanation – A detailed description of the circumstances surrounding your disciplinary action and a thorough description of the rehabilitative changes in your lifestyle since the time of the disciplinary action which would enable you to avoid future occurrences. It would be helpful to include factors in your life, which you feel may have contributed to your disciplinary action, what you have learned about yourself since that time, and the changes you have made that support your rehabilitation.

Applicants with Criminal History

Applicants with prior criminal convictions are required to submit the following:

Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Completion of Probation/Parole/Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Self Explanation – Applicants who have listed offenses on the application must submit a letter in their own words describing the circumstances of the offense. Include in your letter the date of the original offense, the charge, and the jurisdiction where it occurred.

To review the conviction record guidelines adopted by the Board, click here.

Section 456.0635, Florida Statutes (F.S.), requires that health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant:

1. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S., (relating to social and economic assistance), Chapter 817, F.S., (relating to fraudulent practices), Chapter 893, F.S., (relating to drug abuse prevention and control) or a similar felony offense(s) in another state or jurisdiction unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration, unless the sentence and any subsequent period of probation for such conviction or plea ended:
   1. For the felonies of the first or second degree, more than 15 years from the date of the plea, sentence and completion of any subsequent probation;
   2. For the felonies of the third degree, more than 10 years from the date of the plea, sentence and completion of any subsequent probation;
   3. For the felonies of the third degree under section 893.13(6)(a), F.S., more than five years from the date of the plea, sentence and completion of any subsequent probation;
2. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues), unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;
3. Has been terminated for cause from the Florida Medicaid program pursuant to section 409.913, F.S., unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent five years;
4. Has been terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years before the date of the application;
5. Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities. The section above does not apply to candidates or applicants for initial licensure or certification who were enrolled in an educational or training program on or before July 1, 2009, which was recognized by a board or, if there is no board, recognized by the department, and who applied for licensure after July 1, 2012

This license is available only to applicants for licensure by exam or endorsement who have already met the minimum requirement of two years of post-master’s supervised experience but do not meet Florida’s licensure requirements. It allows you to practice under supervision while you meet any additional licensure requirements such as masters level coursework (CSW applicants must have completed 15 semester or 22 quarter hours of clinical coursework), continuing education coursework, or passing the national exam. Provisional licensees are required to meet face-to-face with their supervisor at least one hour per month. A supervisor for a provisional licensee is defined as a Florida Licensed Clinical Social Worker, Marriage and Family Therapist, or Mental Health Counselor. This license is valid for 24 months and cannot be renewed.

Provisional licensure applications are available upon request and will not be provided until an application by endorsement/exam has been received by the Board Office. This application has a non-refundable fee of $100.

To request an application, please contact the Board Office.

To be provisionally licensed (a license to practice under supervision while you meet additional FL licensure requirements such as master’s coursework, CE coursework or passing the national exam – license is valid for 24 months – cannot be renewed) as a CSW/MFT/MHC you must have:

• First applied for licensure by exam/endorsement as a CSW/MFT/MHC in Florida.
• Been approved by the board for the provisional license.

To be licensed as a clinical social worker, marriage and family therapist, or mental health counselor in Florida through the MOBILE Endorsement pathway you must meet the following requirements in section 456.0145, Florida Statutes:

1. Must hold an active, unencumbered license issued by another state, the District of Columbia, or a territory of the United States in a profession with a similar scope of practice, determined by the board or the department, as applicable.
2. Must have obtained a passing score on a national licensure examination or hold a national certification recognized by the board;

OR

An applicant for a profession that does not require a national examination or national certification is eligible for licensure if the applicable board, or the department if there is no board, determines that the jurisdiction in which the applicant currently holds an active, unencumbered license meets established minimum education requirements and, if applicable, examination, work experience, and clinical supervision requirements are substantially similar to the requirements for licensure in that profession in this state.

3. Must have actively practiced the profession for at least two years during the four-year period immediately preceding the date of submission of this application.
4. Must not have ever been reported to the National Practitioner Data Bank, unless the applicant successfully appealed to have the report removed or if the reported adverse action was a result of conduct that would not constitute a violation of any Florida law or rule.
5. Must not be the subject of a disciplinary proceeding in a jurisdiction in which he or she holds a license or by the United States Department of Defense for reason related to the practice of the profession for which the applicant is applying.
6. Must not have had disciplinary action taken in the five years immediately preceding the date of submission of the application.

Refer to section 456.0145(2)(c), Florida Statutes, for licensure ineligibility criteria.

AMFTRB only maintains the contents of the national MFT exam and relationships with its partners delivering the exam and its scoring. AMFTRB does not send scores!

• • For registration, payment, and scores, please review the Handbook for Candidates or contact Professional Testing Corporation (PTC) at 212-356-0660.
  • For all scheduling, rescheduling, and testing center questions, review the Handbook for Candidates or contact Prometric at (800) 741-0934.
  • For training, licensing, and transfer requirements, contact your state board or jurisdiction

Applicants for initial licensure must use a Livescan service provider to submit a set of fingerprints to the Florida Department of Law Enforcement (FDLE) for the purpose of conducting a search for any Florida and national criminal history records that may pertain to applicant. The results of the search will be returned to the Care Provider Background Screening Clearinghouse and made available to the Department for consideration during the licensure process. The fingerprints submitted by the applicant will be retained by FDLE and the Clearinghouse. All costs for conducting a criminal history background screening are borne by the applicant.

It is important to use the correct Originating Agency Identification (ORI) when submitting fingerprints. If you do not provide an ORI number or if you provide an incorrect ORI number to the service provider, the board office will not receive your fingerprint results, so it is extremely important to use the correct ORI when having your fingerprints scanned.

Applicants can use any FDLE approved Livescan service provider to submit their fingerprints. The applicant is fully responsible for selecting the service provider and ensuring the results are reported to the Department.  If you are applying for initial licensure after December 15, 2012, You must print this form and take it with you to a Livescan service provider. For more information, FAQs, and a list of all approved Livescan service providers please visit the Department’s website at: FLHealthSource.gov/Background-Screening.

This license is available only to applicants for licensure by exam or endorsement who have already met the minimum requirement of two years of post-master’s supervised experience but do not meet Florida’s licensure requirements. It allows you to practice under supervision while you meet any additional licensure requirements such as masters level coursework (CSW applicants must have completed 15 semester or 22 quarter hours of clinical coursework), continuing education coursework, or passing the national exam. Provisional licensees are required to meet face-to-face with their supervisor at least one hour per month. A supervisor for a provisional licensee is defined as a Florida Licensed Clinical Social Worker, Marriage and Family Therapist, or Mental Health Counselor. This license is valid for 24 months and cannot be renewed.

Provisional licensure applications are available upon request and will not be provided until an application by endorsement/exam has been received by the Board Office. This application has a non-refundable fee of $100.

To request an application, please contact the Board Office.

To be provisionally licensed (a license to practice under supervision while you meet additional FL licensure requirements such as master’s coursework, CE coursework or passing the national exam – license is valid for 24 months – cannot be renewed) as a CSW/MFT/MHC you must have:

• First applied for licensure by exam/endorsement as a CSW/MFT/MHC in Florida.
• Been approved by the board for the provisional license.

Applicants for initial licensure must use a Livescan service provider to submit a set of fingerprints to the Florida Department of Law Enforcement (FDLE) for the purpose of conducting a search for any Florida and national criminal history records that may pertain to applicant. The results of the search will be returned to the Care Provider Background Screening Clearinghouse and made available to the Department for consideration during the licensure process. The fingerprints submitted by the applicant will be retained by FDLE and the Clearinghouse. All costs for conducting a criminal history background screening are borne by the applicant.

It is important to use the correct Originating Agency Identification (ORI) when submitting fingerprints. If you do not provide an ORI number or if you provide an incorrect ORI number to the service provider, the board office will not receive your fingerprint results, so it is extremely important to use the correct ORI when having your fingerprints scanned.

Applicants can use any FDLE approved Livescan service provider to submit their fingerprints. The applicant is fully responsible for selecting the service provider and ensuring the results are reported to the Department.  If you are applying for initial licensure after December 15, 2012, You must print this form and take it with you to a Livescan service provider. For more information, FAQs, and a list of all approved Livescan service providers please visit the Department’s website at: FLHealthSource.gov/Background-Screening.

Applicants with Health History

If a “Yes” response was provided to any of the questions in this section, provide the following documents directly to the board office:

A letter from a licensed health care practitioner, who is qualified by skill and training to address the condition identified, which explains the impact the condition may have on the ability to practice the profession with reasonable skill and safety. The letter must specify that the applicant is safe to practice the profession without restrictions or specifically indicate the restrictions that are necessary. Documentation provided must be dated within one year of the application date.

A written self-explanation, identifying the medical condition(s) or occurrence(s); and current status.

Applicants with Discipline History

Applicants with prior disciplinary actions are required to submit the following:

Board Actions – Certified copies of document(s) relative to any disciplinary action taken against any license. The documents must come from the agency that took the disciplinary action and must be certified by that agency.

Self-Explanation – A detailed description of the circumstances surrounding your disciplinary action and a thorough description of the rehabilitative changes in your lifestyle since the time of the disciplinary action which would enable you to avoid future occurrences. It would be helpful to include factors in your life, which you feel may have contributed to your disciplinary action, what you have learned about yourself since that time, and the changes you have made that support your rehabilitation.

Applicants with Criminal History

Applicants with prior criminal convictions are required to submit the following:

Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Completion of Probation/Parole/Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Self Explanation – Applicants who have listed offenses on the application must submit a letter in their own words describing the circumstances of the offense. Include in your letter the date of the original offense, the charge, and the jurisdiction where it occurred.

To review the conviction record guidelines adopted by the Board, click here.

Section 456.0635, Florida Statutes (F.S.), requires that health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant:

1. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S., (relating to social and economic assistance), Chapter 817, F.S., (relating to fraudulent practices), Chapter 893, F.S., (relating to drug abuse prevention and control) or a similar felony offense(s) in another state or jurisdiction unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration, unless the sentence and any subsequent period of probation for such conviction or plea ended:
   1. For the felonies of the first or second degree, more than 15 years from the date of the plea, sentence and completion of any subsequent probation;
   2. For the felonies of the third degree, more than 10 years from the date of the plea, sentence and completion of any subsequent probation;
   3. For the felonies of the third degree under section 893.13(6)(a), F.S., more than five years from the date of the plea, sentence and completion of any subsequent probation;
2. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues), unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;
3. Has been terminated for cause from the Florida Medicaid program pursuant to section 409.913, F.S., unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent five years;
4. Has been terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years before the date of the application;
5. Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities. The section above does not apply to candidates or applicants for initial licensure or certification who were enrolled in an educational or training program on or before July 1, 2009, which was recognized by a board or, if there is no board, recognized by the department, and who applied for licensure after July 1, 2012

CLINICAL SOCIAL WORK – Beginning January 1, 2023, applicants shall be deemed eligible to take the examination after the completion of all graduate-level coursework and 18 months of documented experience in clinical settings. These 18 months do not include the applicant’s practicum or other experience received in the applicant’s graduate program. Applicants must request exam approval prior to contacting their test provider. To request exam approval, email MQA.491@flhealth.gov.

Please send the registration fee of $260 DIRECTLY TO Association of Social Work Boards (ASWB). Board-approved candidates may register on the ASWB website at www.aswb.org for the clinical level of the ASWB National Social Work Exam. Registration forms can also be printed under “Register for the Exam” and faxed or mailed to ASWB if paying with a money order. The exam is offered Monday through Saturday by individual appointment computer-based format worldwide. To locate a test center, candidates would go to ASWB’s website and select “On Exam Day” under the “Exam” tab. They can then choose “Find an Exam Site Near You”.  ASWB’s website includes an outline of the clinical-level exam content, an exam site list, and a candidate handbook.

Special accommodations information can be found under nonstandard testing arrangements.  Select the “Exam” tab to learn more and download the form to request for nonstandard Testing arrangements. These requests must be made through ASWB. Candidates may request an English as a Second Language (ESL) Form by contacting ASWB Candidate Services at 888.579.3926 or directing questions to the special arrangements team at 800.225.6880, ext. 3250

ASWB Candidate Services Information
Phone: 888.579.3926
Fax: 540.829.0142
Email: info@aswb.org

Passing exam scores will be forwarded to the board in 2-4 weeks. Score transfers must be requested from the exam vendor.

ASWB Clinical

2017

2018

2019

2020

AMFTRB

2018

2019

2020 – Quarter 1

2020 – Quarter 2

2020 – Quarter 3

2020 – Quarter 4

2021 – Quarter 1

2021 – Quarter 2

2021 – Quarter 3

2021 – Quarter 4

2022 – Quarter 1

2022 – Quarter 2

2022 – Quarter 3

2022 – Quarter 4

2023 – Quarter 1

2023 – Quarter 2

2023 – Quarter 3

2023 – Quarter 4

2024 – Quarter 1

2024 – Quarter 2

2024 – Quarter 3

NCMHCE

2017

2018

2019

2020

2021

2022

2023

2024

Special examination accommodations can be provided for candidates with visual, sensory or physical disabilities that would prevent them from taking the examination under standard conditions; candidates with diagnosed learning or emotional challenges; and candidates for whom English is a second language. Candidates who are Sabbath-observant can also request a non-Saturday examination date. All special examination accommodation requests must be submitted at least 45 days before the exam date and must be on letterhead and signed by the appropriate authority.

Special examination accommodations information and applications are found in the candidate handbook and are available for download from the NBCC website at https://www.nbcc.org/exams/accommodations. These requests must be made through NBCC during the exam registration process. Candidates may contact the special accommodations department by emailing accommodations@cce-global.org.

National Board of Certified Counselors (NBCC)
Phone: 336.547.0607 | Fax: 336.547.0017
Email: nbcc@nbcc.org

To obtain Limited Licensure in Florida you must:

• Be retired or intend to retire from the practice of clinical social work, marriage and family therapy or mental health counseling
• Have been actively licensed in another state for at least 10 years in the same profession as you are applying for a limited license in Florida
• Only practice in the employ of public agencies or institutions or nonprofit agencies or institutions which meet the requirements of s. 501(c)(3) of the Internal Revenue Code, and which provide professional liability coverage for acts or omissions of the limited licensee. A limited licensee may provide services only to the indigent, underserved, or critical need populations within the state. The standard for determining indigency shall be that recognized by the Federal Poverty Income Guidelines produced by the United States Department of Health and Human Services

Applicants for initial licensure must use a Livescan service provider to submit a set of fingerprints to the Florida Department of Law Enforcement (FDLE) for the purpose of conducting a search for any Florida and national criminal history records that may pertain to applicant. The results of the search will be returned to the Care Provider Background Screening Clearinghouse and made available to the Department for consideration during the licensure process. The fingerprints submitted by the applicant will be retained by FDLE and the Clearinghouse. All costs for conducting a criminal history background screening are borne by the applicant.

It is important to use the correct Originating Agency Identification (ORI) when submitting fingerprints. If you do not provide an ORI number or if you provide an incorrect ORI number to the service provider, the board office will not receive your fingerprint results, so it is extremely important to use the correct ORI when having your fingerprints scanned.

Applicants can use any FDLE approved Livescan service provider to submit their fingerprints. The applicant is fully responsible for selecting the service provider and ensuring the results are reported to the Department.  If you are applying for initial licensure after December 15, 2012, You must print this form and take it with you to a Livescan service provider. For more information, FAQs, and a list of all approved Livescan service providers please visit the Department’s website at: FLHealthSource.gov/Background-Screening.

Applicants with Health History

If a “Yes” response was provided to any of the questions in this section, provide the following documents directly to the board office:

A letter from a licensed health care practitioner, who is qualified by skill and training to address the condition identified, which explains the impact the condition may have on the ability to practice the profession with reasonable skill and safety. The letter must specify that the applicant is safe to practice the profession without restrictions or specifically indicate the restrictions that are necessary. Documentation provided must be dated within one year of the application date.

A written self-explanation, identifying the medical condition(s) or occurrence(s); and current status.

Applicants with Discipline History

Applicants with prior disciplinary actions are required to submit the following:

Board Actions – Certified copies of document(s) relative to any disciplinary action taken against any license. The documents must come from the agency that took the disciplinary action and must be certified by that agency.

Self-Explanation – A detailed description of the circumstances surrounding your disciplinary action and a thorough description of the rehabilitative changes in your lifestyle since the time of the disciplinary action which would enable you to avoid future occurrences. It would be helpful to include factors in your life, which you feel may have contributed to your disciplinary action, what you have learned about yourself since that time, and the changes you have made that support your rehabilitation.

Applicants with Criminal History

Applicants with prior criminal convictions are required to submit the following:

Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Completion of Probation/Parole/Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Self Explanation – Applicants who have listed offenses on the application must submit a letter in their own words describing the circumstances of the offense. Include in your letter the date of the original offense, the charge, and the jurisdiction where it occurred.

To review the conviction record guidelines adopted by the Board, click here.

Section 456.0635, Florida Statutes (F.S.), requires that health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant:

1. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S., (relating to social and economic assistance), Chapter 817, F.S., (relating to fraudulent practices), Chapter 893, F.S., (relating to drug abuse prevention and control) or a similar felony offense(s) in another state or jurisdiction unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration, unless the sentence and any subsequent period of probation for such conviction or plea ended:
   1. For the felonies of the first or second degree, more than 15 years from the date of the plea, sentence and completion of any subsequent probation;
   2. For the felonies of the third degree, more than 10 years from the date of the plea, sentence and completion of any subsequent probation;
   3. For the felonies of the third degree under section 893.13(6)(a), F.S., more than five years from the date of the plea, sentence and completion of any subsequent probation;
2. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues), unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;
3. Has been terminated for cause from the Florida Medicaid program pursuant to section 409.913, F.S., unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent five years;
4. Has been terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years before the date of the application;
5. Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities. The section above does not apply to candidates or applicants for initial licensure or certification who were enrolled in an educational or training program on or before July 1, 2009, which was recognized by a board or, if there is no board, recognized by the department, and who applied for licensure after July 1, 2012

To be dually licensed as a Marriage and Family Therapist in Florida you must:

• Be actively licensed in Florida for a minimum of three years as a Clinical Social Worker (LCSW), Mental Health Counselor (LMHC) Psychologist or an Advanced Practice Registered Nurse (APRN)(certified under Section 464.012 Florida Statute, as a specialist in psychiatric mental health by the Board of Nursing)
• Pass the national examination developed by the Examination Advisory Committee of the Association of Marital and Family Therapy Regulatory Boards (AMFTRB) and Professional Examination Services

Applicants with Health History

If a “Yes” response was provided to any of the questions in this section, provide the following documents directly to the board office:

A letter from a licensed health care practitioner, who is qualified by skill and training to address the condition identified, which explains the impact the condition may have on the ability to practice the profession with reasonable skill and safety. The letter must specify that the applicant is safe to practice the profession without restrictions or specifically indicate the restrictions that are necessary. Documentation provided must be dated within one year of the application date.

A written self-explanation, identifying the medical condition(s) or occurrence(s); and current status.

Applicants with Discipline History

Applicants with prior disciplinary actions are required to submit the following:

Board Actions – Certified copies of document(s) relative to any disciplinary action taken against any license. The documents must come from the agency that took the disciplinary action and must be certified by that agency.

Self-Explanation – A detailed description of the circumstances surrounding your disciplinary action and a thorough description of the rehabilitative changes in your lifestyle since the time of the disciplinary action which would enable you to avoid future occurrences. It would be helpful to include factors in your life, which you feel may have contributed to your disciplinary action, what you have learned about yourself since that time, and the changes you have made that support your rehabilitation.

Applicants with Criminal History

Applicants with prior criminal convictions are required to submit the following:

Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Completion of Probation/Parole/Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Self Explanation – Applicants who have listed offenses on the application must submit a letter in their own words describing the circumstances of the offense. Include in your letter the date of the original offense, the charge, and the jurisdiction where it occurred.

To review the conviction record guidelines adopted by the Board, click here.

Section 456.0635, Florida Statutes (F.S.), requires that health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant:

1. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S., (relating to social and economic assistance), Chapter 817, F.S., (relating to fraudulent practices), Chapter 893, F.S., (relating to drug abuse prevention and control) or a similar felony offense(s) in another state or jurisdiction unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration, unless the sentence and any subsequent period of probation for such conviction or plea ended:
   1. For the felonies of the first or second degree, more than 15 years from the date of the plea, sentence and completion of any subsequent probation;
   2. For the felonies of the third degree, more than 10 years from the date of the plea, sentence and completion of any subsequent probation;
   3. For the felonies of the third degree under section 893.13(6)(a), F.S., more than five years from the date of the plea, sentence and completion of any subsequent probation;
2. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues), unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;
3. Has been terminated for cause from the Florida Medicaid program pursuant to section 409.913, F.S., unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent five years;
4. Has been terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years before the date of the application;
5. Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities. The section above does not apply to candidates or applicants for initial licensure or certification who were enrolled in an educational or training program on or before July 1, 2009, which was recognized by a board or, if there is no board, recognized by the department, and who applied for licensure after July 1, 2012

Applicants for initial licensure must use a Livescan service provider to submit a set of fingerprints to the Florida Department of Law Enforcement (FDLE) for the purpose of conducting a search for any Florida and national criminal history records that may pertain to applicant. The results of the search will be returned to the Care Provider Background Screening Clearinghouse and made available to the Department for consideration during the licensure process. The fingerprints submitted by the applicant will be retained by FDLE and the Clearinghouse. All costs for conducting a criminal history background screening are borne by the applicant.

It is important to use the correct Originating Agency Identification (ORI) when submitting fingerprints. If you do not provide an ORI number or if you provide an incorrect ORI number to the service provider, the board office will not receive your fingerprint results, so it is extremely important to use the correct ORI when having your fingerprints scanned.

Applicants can use any FDLE approved Livescan service provider to submit their fingerprints. The applicant is fully responsible for selecting the service provider and ensuring the results are reported to the Department.  If you are applying for initial licensure after December 15, 2012, You must print this form and take it with you to a Livescan service provider. For more information, FAQs, and a list of all approved Livescan service providers please visit the Department’s website at: FLHealthSource.gov/Background-Screening.

The telehealth provider registration is for health care practitioners licensed outside of Florida ONLY. Florida licensees can already provide telehealth services to patients in Florida that they can treat in person.

Florida Practitioners

If you would like to provide services to a client outside of the state of Florida, you must contact the board in the jurisdiction where the patient is located. Not all states permit telehealth service even under emergency circumstances.

Florida Registered Interns

Pursuant to rule 64B4-2.002, Florida Administrative Code, registered interns may provide face-to-face psychotherapy by electronic methods if the registered intern has a written telehealth protocol and safety plan in place with their current qualified supervisor which includes the provision that the qualified supervisor must be readily available during the electronic therapy session.  Additionally, the registered intern and their qualified supervisor must have determined, through their professional judgement, that providing face-to-face psychotherapy by electronic methods is not detrimental to the patient, is necessary to protect the health, safety, or welfare of the patient, the registered intern, or both, and does not violate any existing statutes or regulations.

Qualified supervisors may utilize face-to-face electronic methods, including telephone only communication, to conduct all supervisory sessions for internship hours if the qualified supervisor determines, through their professional judgment, that such methods are not detrimental to the registered intern’s patients and are necessary to protect the health, safety, or welfare of the qualified supervisor, the registered intern, or both.

Any clinical hours obtained via face-to-face psychotherapy by electronic means shall be considered clinical hours for the purpose of meeting internship requirements.

For further information regarding telehealth guidelines, please click here.

Health care practitioners with an out-of-state license or certification that falls under section 456.47(1)(b), F.S, qualify for an out-of-state telehealth provider registration number when they meet the following requirements:

• Submit the completed Application for Out-of-State Telehealth Provider Registration
• Maintain an active, unencumbered license from another state, the District of Columbia, or a possession or territory of the United States (license verification is required);
• Not have a pending investigation, discipline, or revocation on your license within the last five years;
• Designate a duly appointed registered agent for service of process in Florida (see Application for Out-of-State Telehealth Provider Registration)
• Maintain liability coverage or financial responsibility for telehealth services provided to patients in Florida in an amount equal to or greater than Florida health care practitioner requirements
• Not open a Florida office or provide in-person health care services to Florida patients
• Only use a Florida-licensed pharmacy, registered nonresident pharmacy, or outsourcing facility to dispense medicinal drugs to patients in Florida (pharmacists only)

Out-of-State Health Care Practitioners

Out-of-state health care practitioners must be registered with the Florida Department of Health to perform telehealth services for patients in Florida. The out-of-state telehealth provider registration is for health care practitioners licensed outside of Florida ONLY. Florida licensees can already provide telehealth services to patients in Florida that they can treat in person.

Pursuant to section 491.014(4)(d), Florida Statutes, you may practice under a limited basis without a license as specified below:

4. No person shall be required to be licensed, provisionally licensed, registered, or certified under this chapter who:
   4. Is not a resident of this state but offers services in this state, provided:
      1. Such services are performed for no more than 15 days in any calendar year; and
      2. Such nonresident is licensed or certified to practice the services provided by a state or territory of the United States or by a foreign country or province.

The Department has created a website that allows interested parties to review information about Florida telehealth, sign up for updates, and register to become an out-of-state telehealth provider. Learn more about becoming an out-of-state Designated Registered Agent.

For questions, contact the Telehealth Office at MQA.Telehealth@flhealth.gov.