Mandatory Online Renewals Reminder
On March 5, 2024, Rule 59A-35.060(2), Florida Administrative Code, required all providers to submit license renewal application forms, fees, and supporting documents electronically through the Online Licensing System. Effective September 5, 2024, renewal applications submitted by mail will not be accepted and will be returned to the provider. Renewals are required to be filed by a specific deadline and must be submitted on time electronically.
Applicants must register an AHCA Portal account to apply online. If you are not already registered to apply online, click the link and follow the instructions to sign up: Access Online Licensing.
Online licensing instructional videos are available here.
Licensure Forms For All Applicants As Required By Law
The following licensure application forms are for use by health care providers regulated under Chapter 408, Part II, Florida Statutes.
Licensure and/or certification forms for the following provider types may be found below:
Submit Online - Pursuant to Rule 59A-35.060, providers must submit renewal applications through the Agency's Online Licensing System indicated below. Initial applications and change during licensure period applications may also be submitted online through the Agency's Online Licensing System indicated below.
Tips for submitting applications:
- Make check/money order payable to the Agency for Health Care Administration (AHCA).
- If payment is made out to the State of Florida or CLIA, it will be returned.
- Payments for application fees must accompany the application.
- If payment is not submitted with the application, it will be returned.
- Renewal Applications must be submitted and paid prior to the expiration date.
- Renewals may be submitted not more than 120 days before expiration.
Forms for All Provider Types
Forms for use by all provider types.
Health Care Licensing Application Addendum AHCA Form 3110-1024
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144 kB
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Attestation of Compliance with Background Screening Requirements AHCA Form 3100-0008
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177.2 kB
]
Forms for Multiple Provider Types
The below forms are used by some provider types.
Proof of Financial Ability to Operate, AHCA Form 3100-0009
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431 kB
]
149.7 kB
]
