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Fingerprint Card Requests

If you live out-of-state or are unable to access electronic Live Scan services in the state of California, you must complete the criminal history record check by submitting fingerprint cards.

Instructions

  1. Obtain two (2) fingerprint cards (form FD-258) directly from your local law enforcement agency, authorized fingerprint service agency, or contact the Board. The DOJ will reject or return all other fingerprint card forms.

  2. Complete all areas on both cards as indicated in the example (PDF).

  3. Visit a local law enforcement agency or an authorized fingerprinting agency to have your fingerprints ink-rolled directly onto the cards. Ensure that the cards include all required information and that the information is legible. Ensure that the cards have distinctive sets of impressions and the impressions on the second card are not duplicates of the first card.

  4. Pay the rolling fee (service fee) directly to the agency. The rolling fee is separate from the fingerprint card processing fee which is paid directly to the Board at the time of applying for licensure.

  5. Mail the completed fingerprint cards to: Physician Assistant Board, 2005 Evergreen Street, Suite 2250, Sacramento, CA 95815. DO NOT FOLD CARDS.

  6. Include a check, cashier’s check, or money order payable to the Physician Assistant Board in the amount of $49, only if this fee was not paid at the time of applying for licensure.

  7. The Board submits fingerprint cards to the Department of Justice (DOJ) and Federal Bureau of Investigation (FBI) for processing weekly and the results are typically transmitted to the Board within 2-4 weeks.

The results of a criminal history record check may be delayed for a variety of reasons; some of which include poor fingerprint quality or incorrect data.

  • When a fingerprint card is rejected due to poor quality of impressions, the Board must submit a second fingerprint card to the DOJ/FBI for processing which may delay receiving the results of the criminal history record check for up to 2-4 weeks. The DOJ/FBI will not process the second card if the impressions are duplicates of the first card; therefore, please ensure your prints are rolled twice by the fingerprint roller.

  • When the second fingerprint card is rejected due to poor quality of impressions, a name check is automatically completed by the DOJ/FBI which may delay the receiving the results of the criminal history record check for up to 30 days.