- FEE (See Renewal Dates and Fees)
- SIG (Signature regarding the completion of Continuing Education, included in on-line renewal and paper form see Continuing Education Information for details)
- CPR (Current CPR/AED certification is required)
- INS (Malpractice liability insurance is required. If renewing via paper form, you must also submit Form 2543.)
- WHD (Work History is requested. If renewing via paper form, you must also submit Form 2543.)
- EPF (Evaluation and Treatment Protocol Form 2517 is to be completed and filed at the place of employment. If renewing via paper form, you must also submit Form 2543.)
- If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at
(608) 266-2112 or
|RDAF||Renewal Dates and Fees|
|R210||Active Duty/Discharge Renewal Extension|
|2543||Additional Requirements for Renewal |
|2517||Evaluation and Treatment Protocol (to be completed and filed at the place of employment)|
|2254||Convictions and Pending Charges (if applicable for renewal)|
Wisconsin Act 210 (effective June 1, 2012)
This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.
This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.
Service members and spouses may request extensions of licenses beyond 180 days from
discharge and may request a waiver or extension of time to complete continuing
education requirements due to hardship. Please view Active
Duty/Discharge Renewal Extension Form R210 for further information.