Florida Department of State and Division of Library and Information Services

Reference: Ref-03402

Reference Name: Affidavit of Compliance with Background Screening Requirements, AHCA Form 3100-0008, September 2013
Agency: 59 Agency for Health Care Administration
59A Health Facility and Agency Licensing

Modified Document(s):
3/8/2018 Page 1 (f) was inadvertently left off. (f) has been re-added.
Original Document(s):
11/5/2013 The Affidavit of Compliance with Background Screening Requirements, AHCA Form 3100-0008, September 2013 is used by ...
Description: The Affidavit of Compliance with Background Screening Requirements, AHCA Form 3100-0008, September 2013 is used by individuals to attest that they meet qualifications for employment in accordance with the standards in 408.809, F.S.

Disclaimer: External links within the reference material are subject to change outside of the rulemaking process.

Rules/Notices using this Reference Material
Notice /
Adopted		 Section Description ID Publish
Date
View Text Final
59A-35.090 		Background Screening; Prohibited Offenses. 13899147 Effective:
12/16/2013



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