Get Fl Dh-mqa 1124 2021-2025

Completing the FL DH-MQA 1124 form online is a straightforward process that ensures you provide the necessary information for your Advanced Practice Registered Nurse (APRN) licensure. This guide offers a step-by-step approach to assist you in accurately filling out the form without missing any key details.

Follow the steps to complete the FL DH-MQA 1124 form effectively.

1. Press the ‘Get Form’ button to acquire the application form and open it in your web editor.
2. Begin by entering your personal information. Fill in your full name (last, first, middle), date of birth, and mailing address, ensuring all details are accurate.
3. Complete the Equal Opportunity Data section. This section is voluntary, but providing this information helps with compliance and reporting.
4. Fill in your Social Security Number as required. Remember, this information is exempt from public records disclosure.
5. In the Applicant Background section, list any previous names, nursing licenses held, and your original state of licensure. You may need to submit verification from those states.
6. Detail your education history. Include the schools you attended, degrees received, and the dates of attendance, especially for nursing education.
7. You will need to answer health history questions regarding physical and mental health disorders. If any apply, be prepared to provide documentation.
8. Complete the discipline and criminal history sections. Be honest and thorough, as any discrepancies may affect your application.
9. If applicable, provide information related to criminal history and previous disciplinary actions taken against you.
10. Review the liability claims and Livescan privacy statements before confirming your understanding and compliance.
11. Finally, provide your signature and the date to certify that the information provided is accurate. You can then save, download, or print your completed form.

Submit your application online to ensure efficient processing and timely approval.