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LicensE, our new, online, self-guided occupational license application platform is now live! The list of licenses available via LicensE plus user guides and other resources are available
HERE. Anyone applying for an initial license for any of the credentials listed can apply at license.wi.gov.
LicensE is for new, initial applications only. To renew your license, click HERE.
Wis. Stat. § 440.08 (2), the required renewal date for the Licensed Midwives credential is 06/30/even years. Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.
An applicant who fails to comply with a request for information related to the application, or fails to meet all requirements for a permit within 120 calendar days from the date of filing shall submit a new application and fee if a permit is sought at a later date.
- All Licensed Midwives must be registered with the State Vital Records Office, Division of Public Health in the Department of Health and Family Services in order to file birth certificate information:
Wisconsin Vital Records
P.O. Box 309
Madison, WI 53701
Pre-Credential Education Information
Obtain certification from one of the following:
Obtain certification for use of automated external defibrillators (AED's), through a program approved by the Wisconsin
Department of Health Services (DHS).
A temporary permit allows the applicant to practice midwifery under the direct supervision of a licensed midwife pending successful completing the requirements for a license.
- An applicant may receive a temporary permit by completion of all application requirements and payment of a $10.00 fee.
- The permit is valid for three (3) years, or until the permit holder ceases to be currently registered or actively engaged as a candidate for nation certification, whichever comes first.
- Temporary permits may be renewed once at the Department's discretion for a period of no more than three (3) years. A permit holder seeking renewal must submit documentation to the Department that satisfies the requirements for an initial permit.
Application for Licensure
||Application for Licensed Midwife |
|3217||Application for Fee Reduction (This form must accompany the application for the credential)|
2790||Request for Temporary Permit for Licensed Midwife |
3194||Request for Verification of Preceptorship-Apprentice Relationship|
2793||Request for Verification of Certification |
||Malpractice Suits or Claims Form (If applicable)|
|2795||Informed Consent Form|
3086||Application for Predetermination (Optional-Submit only if you have been
convicted of any felony, misdemeanor, or other violations of federal, state, or
local law, including municipal ordinances, in this state or any other and you desire a review of your conviction record before applying for a
||Convictions and Pending Charges, if applicable|
3071||Fax Payment Form|