Criminal History Record Checks for Maryland Applicants
This document outlines the requirements and procedures for submitting a Criminal History Record Check (CHRC) for Maryland licensure. It includes essential details about fingerprinting and timing of submissions. Following these instructions will ensure a smooth application process for practitioners.
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How do I fill this out?
To fill out this document, first ensure you have the required documents and fees ready. Next, complete the fingerprinting process as outlined in the instructions. Finally, submit your application along with the CHRC results to the Board.

How to fill out the Criminal History Record Checks for Maryland Applicants?
1
Gather the necessary documents and fees.
2
Visit an authorized fingerprinting location.
3
Submit two sets of fingerprints to CJIS.
4
Wait for the CHRC results.
5
Complete your application submission to the Board.
Who needs the Criminal History Record Checks for Maryland Applicants?
1
Physicians applying for a new license need to verify their criminal history.
2
Allied health practitioners require CHRC to ensure compliance for patient safety.
3
Applicants seeking reinstatement of their license need to provide updated criminal history records.
4
Out-of-state applicants must fulfill CHRC requirements to practice in Maryland.
5
Anyone applying for governmental certification needs to pass a criminal background check.
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What are the instructions for submitting this form?
To submit this form, complete the required fields and provide your fingerprints as instructed. You may mail your application along with the payment to the address listed. For any inquiries, contact CJIS at 410-764-4501 for assistance.
What are the important dates for this form in 2024 and 2025?
For applicants in 2024, ensure all CHRC submissions and applications are processed by the Board before the overview deadlines. The deadlines for CHRC submissions are typically 90 days prior to your application submission date.

What is the purpose of this form?
The purpose of this form is to verify the criminal background of applicants for licensure in Maryland’s healthcare sector. It ensures that all practitioners meet the necessary legal and safety standards required to operate. This form protects the public by maintaining rigorous checks on individual qualifications to practice.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant Information: This field collects personal details including name, address, and contact information.
- 2. Fingerprint Submission: This section requires information on fingerprinting details and method of submission.
- 3. Payment Details: This field captures payment method and amount required for processing the CHRC.
What happens if I fail to submit this form?
Failure to submit the CHRC can result in the denial of your licensure application. Additionally, it may delay the processing of your application, requiring resubmission.
- Licensure Denial: Without a submitted CHRC, the Board cannot consider your application.
- Processing Delays: Your overall application timeline may be significantly extended.
How do I know when to use this form?

- 1. Initial Licensure: First-time applicants must submit this form as part of their application.
- 2. License Reinstatement: Returning practitioners are required to complete this process to renew their credentials.
Frequently Asked Questions
What is a Criminal History Records Check?
A Criminal History Records Check is a procedure that verifies an individual's criminal history through state and national databases.
Who needs to submit a CHRC?
All applicants seeking licensure or reinstatement in Maryland must submit a CHRC.
How do I submit my fingerprints?
You can submit your fingerprints at an authorized location or through mailing fingerprint cards.
What if my CHRC is older than 90 days?
You will need to complete a new CHRC as the Board only retains records for 90 days.
Can I edit the PDF after downloading?
Yes, you can make edits directly on PrintFriendly before downloading.
How do I pay for the CHRC?
Payment can be made via check, credit card, or cashier's check, but not cash.
How do I challenge my CHRC results?
You have the right to challenge your results as detailed in the FBI Non-Criminal Justice Applicant's Privacy Rights notice.
What is the timeline for CHRC processing?
The Board recommends not submitting fingerprints earlier than 6 weeks before your application.
How do I contact CJIS for questions?
You can email CJIS Customer Service or call their helpline for assistance.
What happens if I don’t submit the CHRC?
Your application for licensure will not be processed, and you cannot obtain a license.
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