Get Fl Dh-mqa 1150 2012-2025

The FL DH-MQA 1150 form is essential for individuals seeking licensure as a registered chiropractic assistant in Florida. This guide provides a clear path for completing the form accurately and effectively online.

Follow the steps to fill out the FL DH-MQA 1150 online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by typing or printing your name clearly in the spaces provided for last name, first name, and middle name.
3. Enter your Social Security Number as required for identification and processing.
4. Respond to the applicant history questions, using additional sheets if necessary to provide complete information for any 'YES' answers.
5. Provide your mailing address, and primary practice address, ensuring you include the street, city, state, and zip code.
6. Include your contact telephone numbers, indicating which is your primary contact number.
7. Fill out your email address, birth date, and birth place, making sure the information is accurate.
8. Complete the citizenship and race sections as requested, keeping in mind this information is for statistical purposes.
9. Answer the criminal history and licensure actions questions truthfully. Provide necessary details for 'YES' responses.
10. Review your application statement and ensure you authorize the necessary information releases, providing your signature and the date.
11. Finally, save changes to your completed form, then download it, print it, or share it as needed, along with any required fees.

Complete your FL DH-MQA 1150 application online today to move forward in your chiropractic assistant career.