What is this? A request for evaluation of your criminal history and potential eligibility for licensure prior to application for licensure as a physician, physician assistant, acupuncturist, medical radiologic technologist, non-certified radiological technician, respiratory care practitioner, medical physicist, or perfusionist.
Please note that this evaluation is not a guarantee of eligibility for licensure. Applicants must meet all licensure requirements that are in place at the time of their licensure application submission.
This is important! Do not apply for a Pre-Licensure Criminal History Evaluation Letter if you are a current licensure applicant or you currently hold an active license to practice in Texas. Licensure applicants will have criminal history evaluated as part of the licensure application.
Chapter 161.1 of the Board’s rules addresses criminal history evaluation letters. These rules can be viewed in the Board Rules section of our website.
You must download and complete the application below, and submit it to the Board along with a fee of $100.
Once your application is received, you will be issued a six-digit identification number so that you can register to Get Fingerprints. Fingerprinting services will be provided by IdentoGo by IDEMIA for a fee, payable directly to IdentoGo. Results of the fingerprinting will be sent directly to TMB both from the Texas Department of Public Safety Criminal Records and the Federal Bureau of Investigation.
Pre-Licensure Criminal History Evaluation Request Form