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NCQA CErtification

 

 IMPORTANT MESSAGE 

Effective February 6, 2014, the procedure for identity verification is as follows:

  • Each new applicant is required to complete and mail a Certification of Identification (CID) form, with the exception of those designating to Arizona Medical Board, Oregon Medical Board or Vermont Board of Medical Practice.
    •  The exceptions for these Boards are detailed on page 2 of the download document.
    •  The CID form requires notarization and attachment of a photocopy of your birth certificate or a photocopy of your passport.
  •  Download the Certification of Identification form and instructions.

 

FEDERATION CREDENTIALS VERIFICATION SERVICE (FCVS)

RELATED LINKS

 FCVS for...
  Physicians
  Physician Assistant
  State Medical Boards
  Credentialing Professionals

 Additional Resources
  Login/Check FCVS Status
  Updates
  Tips
  Fees

 

FCVS Physician Application

The FCVS application captures pertinent information in an efficient and easy-to-understand manner. Contact a Customer Support Representative at 1-888-ASK-FCVS or email for assistance with completing an application.

New FCVS User
Subsequent FCVS User
Check FCVS Status

New FCVS User
For new applicants and those individuals who have begun the FCVS verification process but who have not yet had their credentials verified.

Note: If you would prefer a paper application, email FCVS and please indicate whether you are a domestic or international graduate. An additional $50 processing fee will be incurred if submitting a paper application.

FCVS Physician Forms
FCVS requires the original Affidavit and Release form, original Certification of Identification form and either a copy of your birth certificate or a copy of your passport; these must be mailed. All other required forms may be uploaded in your application or mailed to the following address:

Federation Credentials Verification Service (FCVS)
Federation of State Medical Boards
400 Fuller Wiser Road, Suite 300
Euless, TX 76039

Affidavit and Release form and Certification of Identification form with instructions

  • Complete the information requested and sign the form in the space provided at the bottom of the page.
  • This form must be included with all correspondence to your source institutions to allow them to complete our verification requests.

ECFMG Release Forms (International Graduates only)

NBME Examination History Release Form

  • Complete this form if you have taken any or all parts of the National Board of Medical Examiners (NBME) examination (i.e., Parts I, II or III). This form must be dated within one year of FCVS request to NBME and requires a hand-written signature and date.

Returning FCVS User
For those individuals who have an established, verified FCVS profile and are now requesting to have an additional profile forwarded to another state licensing authority or entity of their choice.

Information previously entered in your Initial Application will automatically be entered in the Subsequent Application, with the ability to update some information and to submit the application electronically.

Note: If you would prefer a paper application, please email FCVS to request a paper subsequent application. An additional $25 processing fee will be incurred if submitting a paper subsequent application. An affidavit and CID is not required for subsequent applications, if appropriate documents are in the established file.

Subsequent FCVS Application Process
FCVS stores all documents related to your identity, medical education and postgraduate training. These documents are permanently stored in your FCVS portfolio; however, are reviewed with each subsequent application and may require additional contact with the institution(s) if the documents do not meet specific board requirements.

Data reported on examination score transcripts and confirmation of ECFMG Certification is considered proprietary by the issuing organizations; therefore FCVS is specifically prohibited from storing and duplicating these documents. Additional time and surcharges may be required for FCVS to obtain original documents from these institutions.

Please note that any updates to your portfolio (i.e. additional training or completion of training that was previously in progress) require additional contact with the institution(s).

The average processing time will vary with the complexity of the portfolio. Our goal is to process the Subsequent Application and forward it to your requested designation(s) as quickly as possible.

 

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