Applicant Checklist
You may print and keep this checklist as a reminder of what forms you need to file. This is for your reference and should not be submitted with your application forms. You should also keep a copy of all application forms submitted.
Online Form 1 - Application for Licensure
All applicants for licensure must initially submit Form 1 along with the $322 licensure and first registration fee. You must answer all questions and provide all information requested unless otherwise indicated. Failure to accurately complete all required parts of the application will delay its review. Additional forms below are required based on the licensure requirements of the profession. Do not use Form 1 to renew your existing license.
Continuing Your Application
If you have started an application within the past 30 days, and have not yet completed it, you can use this link to continue your application. You will need your Application ID, Social Security Number, and Date of Birth.
Upload Additional Documentation
If you have already completed an application, but you have additional documents or files to include in your previous submission, use this link to upload additional documentation. You will need your Application ID and Date of Birth.
You are required to notify us within 30 days of any address or name changes. Please read the instructions to request this change.
Form 2 - Certification of Professional Education
This form must be submitted directly by the professional school you attended.
- Section I: Complete this section of the form before sending it to the professional school(s) verifying your professional education. Be sure to sign and date item 8. Send this form to the school(s) you attended and ask them to complete the appropriate section of the form. Be sure to include any fee required by the school. A separate Certification of Professional Education must be submitted for each educational program attended.
- Section II: The Registrar must complete this section and return the form directly to the Office of the Professions at the address at the end of the form.
Note: If you graduated after December, 1995, completed the pharmacology and law courses at the same institution where you completed your New York State registered, licensure qualifying midwifery program, AND that institution is located in New York State, you do NOT have to complete either Form 2A or Form 2B. If the institution is located outside of New York State, you must still complete a Form 2B.
Form 2A - Certification Of Pharmacology Course Or The Equivalent Of Not Less Than Three Semester Hours
This form must be submitted directly by the institution providing the pharmacology course.
- Section I: Complete this section of the form. Be sure to sign and date item 7 and send it to the institution that provided the pharmacology course. Ask the institution to verify your attendance at the three-hour pharmacology course (or equivalent) by completing the appropriate section of the form. Be sure to include any fee required.
- Section II: The Registrar must complete this section and return the form directly to the Office of the Professions at the address at the end of the form.
Form 2B - Certification of Instruction In New York State And Federal Laws Relating To Prescriptions And Record Keeping
This form must be submitted directly by the institution/organization providing the instruction in New York State and federal laws relating to prescriptions and record keeping.
- Section I: Complete this section of the form. Be sure to sign and date item 7 and send it to the institution/organization that provided the instruction in New York State and federal laws relating to prescriptions and record keeping. Ask the institution/organization to verify your completion on the appropriate section of the form. Be sure to include any fee required.
- Section II: The Registrar or appropriate institution/organization official must complete this section and return the form directly to the Office of the Professions at the address at the end of the form.
Online Form 5 - Application for Limited Permit for Midwife
All applicants for a limited permit must initially submit Form 5 along with the $70 permit fee. You must also submit a Form 5CS - Certification of Supervisor for Limited Permit along with your application.
Continuing Your Application
If you have started an application within the past 30 days, and have not yet completed it, you can use this link to continue your application. You will need your Application ID and Date of Birth.
Upload Additional Documentation
If you have already completed an application, but you have additional documents or files to include in your previous submission, use this link to upload additional documentation. You will need your Application ID and Date of Birth.
Changes to Supervisors and/or Settings
If you change supervisors and/or settings, or you have to add or remove a supervisor or setting, after a permit is issued, you must obtain an amended permit using the Limited Permit Change Form. After changes are processed you will receive an amended permit. A fee is not required for an amended permit issued as a result of a change in supervisor or setting. You must also submit a Form 5CS - Certification of Supervisor for Limited Permit for each new supervisor you are adding (see Upload Additional Documentation above)
Form 5CS - Certification of Supervisor for Limited Permit
Use this form ONLY if you are applying/have applied for a New York State Limited Permit as a Midwife online.
- Section I: Complete this section.
- Section II: Your supervisor must complete this section before you can submit it to the Office of the Professions at the appropriate address at the end of the form. It is your responsibility to ensure your supervisor fully completes Section II. Failure to complete this form will delay its review.