The Department of Safety and Professional Services has made changes to remain fully operational during the COVID-19 public health emergency and to support the state response to the crisis. Archived COVID-19 Updates and Information can be found on the COVID-19 Information - Archive page.
Individual licensee/provider temporary license forms:
2021 Wis. Act 10 Forms for Out-of-State Health Care Provider Temporary Practice in Wisconsin
There are two forms related to a temporary credential granted pursuant to 2021 Wis. Act 10:
IMPORTANT NOTE REGARDING PROVIDERS WORKING IN WISCONSIN WHO PRACTICE IN WISCONSIN SOLELY DURING THE NATIONAL COVID PUBLIC HEALTH EMERGENCY: The expiration date of an active Wisconsin interstate reciprocity temporary credential issued pursuant to 2019 Wis. Act 185, Wisconsin Emergency Orders #2, #16, and #20, and/or Wisconsin Executive Order #90 will automatically be extended until 30 days after the national emergency declared by the U.S. president under 50 USC 1621 in response to the 2019 novel coronavirus ends. Providers holding an active temporary credential issued under any of the above provisions do not need to reapply for a temporary credential pursuant to 2021 Wis. Act 10.
If you previously held an Interstate Reciprocity Temporary License during EO 16, EO 20 or Act 185:
If you held a Wisconsin license and it expired within the last five years:
Emergency Order #2 Renewal Form (Form EO2020-3)
** IMPORTANT NOTE - Nurses only: Nurses with licenses expired for five (5) or more years should submit this form.
All others: If your license/certification has been expired for five (5) or more years, or if you have an expired training license/certificate, contact credentialing staff at firstname.lastname@example.org or (608) 266-2112.
If you held a Wisconsin license that has been expired for more than five years:
- Visit your profession's page and submit the application for Late Renewal after 5 years or more
Pharmacy Examining Board Orders