Prevention Specialist

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Who can use LicensE? Applicants for initial health care licenses are our primary LicensE users, but we know many other organizations and institutions will need to submit documents through the platform. Anyone who is not an applicant or a DSPS employee is considered a LicensE third-party user. Third-parties include educational institutions, employers, testing centers, and any other individual or entity who needs to supply documentation on behalf of an applicant. Please see our Additional​ Resources for third-party user guides, demo videos, and more.

LicensE is for new, initial applications only. To renew your license, click HERE. You should not use LicensE to renew your license at this time. If you already have a pending application, you should not apply again in LicensE. Note that applicants who apply multiple times will be charged for each ​application.

​​License Information

Per Wis. Stat. § 440.08 (2), the required renewal date for the Prevention Specialist credential is 02/28/odd 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.

Pursuant to 2017 Wisconsin Act 262, as of May 1, 2018, the requirements to obtain a Prevention Specialist credential have changed.


Pre-Credential Education

Complete 120 hours of approved education, including 50 hours specific to alcohol, tobacco, and other substance abuse and six (6) hours specific to ethics, in the following content areas:

  • Planning and evaluation
  • Prevention education and service delivery
  • Communication
  • Community organization
  • Public Policy and environmental change
  • Professional growth and responsibility


 

Application for Licensure

FormDescription
2745Credentialing Information for Prevention Specialist Applicants
​2786Credentialing Information for Out-of-State Reciprocity Prevention Specialist Applicants
​3217​Application for Fee Reduction (If applying for a fee reduction, this form must accompany the application for the credential.)
​2781​Education and Training Form
​3222​Credentialing Information for Prevention Specialist Late Renewal Applicants (For credentials expired five (5) years or more) ​
2829Malpractice Suits or Claims Form (If applicable)
​3085​Application for Predetermination (Optional-Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal or state law in this state or any other and you desire a review of your conviction record before applying for a credential.)​
2252​Convictions and Pending Charges (If applicable)

3071

​Fax Payment Form

Renewal Information

Requirements

  • FEE (See Renewal Dates and Fees)
  • SIG (Signature regarding the completion of Continuing Education in Chapter SPS 165.01, included in on-line renewal and paper form - see Continuing Education Information for details)
  • 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 dsps@wisconsin.gov.

Renewal Methods

FormDescription
RDAFRenewal Dates and Fees
R210Active Duty/Discharge Renewal Extension

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.