You must complete this form and submit it with the appropriate licensure and initial registration fee ($322) directly to the Office of the Professions to apply for licensure in NYS. $322 is the total of the application fee ($115) plus the fee for your first registration period ($207). The application portion of the fee is not refundable. View the Profession Fee Chart at http://www.op.nysed.gov/documents/opfeechart.pdf. You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review.
Before you begin the application, you should review the requirements for licensure as a Midwife at http://www.op.nysed.gov/prof/midwife/midwifelic.htm. Please take a moment to review the list of necessary information you will need to complete the application process.
- Contact Information, including mail & email addresses and phone number(s)
.
- Information about any criminal (misdemeanor or felony) or professional disciplinary action. You will have the opportunity to upload relevant documents.
- Educational history, including locations and dates.
- Professional experience, including details about any other licenses held.
- Payment information ($322 payment is only accepted by MasterCard, Visa, American Express or Discover)
.
- To save and return to the application you must have a Social Security Number.
If you require assistance with the online application, click the Help link. Application fees are not refundable; it is your responsibility to know the requirements for licensure.
This is the application and fee for licensure as a Midwife. You must also meet requirements for education and examination. You are responsible for having all other documentation submitted for review and approval by the Department.