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Midwife License Application
Student Midwife Provisional
Rules and Statutes
APPLICATION INSTRUCTIONS |
Specific requirements are detailed in the Rules and Regulations which are available on this web page under Rules and Statutes. Please review the requirements prior to submitting an application.
- U.S. Code Title 8, Chapter 14, Section 1621 requires that all licensing agencies collect proof of legal presence in the United States. Generally applicants find it easiest to provide a copy of a state issued birth certificate, a copy of a passport, or a copy of a social security card. Originals will not be returned. Just one (1) form of identification is required. A copy of your driver’s license is not acceptable. If you cannot provide any of these documents, please refer to the enclosed List A and B for other acceptable documents.
- All application files must be completed within one (1) year of the date the application was received by the Board, otherwise the application will be deemed incomplete and closed without further notice. This includes all additional documents required to show that the applicant meets the licensure requirements.
- Application files will be presented to the Application Review Committee (Committee) for consideration when all required documentation has been received.
- The Committee will not review your qualifications without receipt of a formal application and fee.
- Faxed and photocopied documents will not be accepted unless otherwise specified.
- The application fee is $1,200.00. Make checks payable to the “State of Wyoming”. Do not send cash. All fees are non-refundable regardless of the outcome.
- All documents offered in support of the application must be submitted directly to the Committee from the source, not forwarded through you.
- NARM stands for North American Registry of Midwives.
- Contact the Board at Emily.Cronbaugh@wyo.gov to request two (2) fingerprint cards for midwifery licensing. Follow the directions provided with the cards.
- Print the Application for Licensure form.
- Complete the application in its entirety. Incomplete applications will not be reviewed. Make sure that you provide a written explanation if you answered "YES" to any of questions 12 through 20. If more space is needed, attach additional sheets of paper. You must include copies of all legal documents relative to your “Yes” answer. Read the “Warning” and “Agreement and Affidavit”. Remember, you are stating that you have read, and agree to abide by, the rules and regulations. The rules are available on the Board’s web page at http://plboards.state.wy.us/Midwifery/RulesRegs.aspx. Read them. Sign and date the application. Please sign in blue ink.
- If you are currently, or have been previously registered, licensed or certified in another state, in any profession, contact the regulatory board for that state and request that they send a verification of that registration, license or certification directly to the Committee at the address provided below.
- Request that NARM send the Board an official verification of your CPM.
- Request that your MEAC accredited program send the Board a transcript showing completion of the midwifery education program. If you did not graduate from a MEAC accredited program, you must provide:
Mail the complete application (3 pages), proof of legal presence in the United States, and the $1,200.00 application fee, to the Board at the address provided below.
You may be required to appear for a personal interview with the board if the Application Review Committee deems an interview appropriate in general, or in a specific case.
When all supportive documents have been received, along with the criminal history report, your file will be reviewed and you will be informed of the outcome. If approved, you will be issued a wall certificate and one (1) pocket license card.
- Verification of five (5) years of experience practicing as a licensed or certified midwife in another state as instructed in item #4 above, and
- Copies of certificates of attendance verifying that you have completed Board approved courses in the treatment of respiratory distress in newborns, pharmacology, treatment of shock, intravenous therapy, and suturing specific to midwives.
Inquiries regarding these application procedures and application status may be directed to:
Wyoming Board of Midwifery
2001 Capitol Ave, Room 104
Cheyenne WY 82002
Emily Cronbaugh, Licensing Specialist, Emily.Cronbaugh@wyo.gov
Michelle Lamorie, Executive Director, Michelle.Lamorie@wyo.gov
Application for Licensure
List A & B