Florida Department of State and Division of Library and Information Services

Reference: Ref-03401

Reference Name: Application for Exemption, AHCA Form 3110-0019, September 2013
Agency: 59 Agency for Health Care Administration
59A Health Facility and Agency Licensing

Modified Document(s):
1/24/2018 The change updates an outdated phone number to the current number for the Department of Health.
Original Document(s):
11/5/2013 Application for Exemption, AHCA Form 3110-0019, September 2013, to be used by individuals seeking an exemption from ...
Description: Application for Exemption, AHCA Form 3110-0019, September 2013, to be used by individuals seeking an exemption from disqualification from employment as required in 435.07, 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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