Wyoming Board of Midwifery

Application Forms

Midwife by Education Application - For those who have graduated from a midwifery education program accredited by MEAC or a similar successor organization. 

Midwife by Endorsement Application - For those who hold a license in good standing to engage in the practice of midwifery under the laws of another state with requirements at least as stringent as Wyoming.

Midwife by Experience Application - For those who do not have an education through a MEAC accredited school or a license in a state with requirements as stringent as Wyoming, but have 5 years practical experience that meets the requirements in rule.

Provisional License Application (Locum Tenens) - For those who are licensed or certified in another state with requirements at least as stringent as Wyoming to practice for not more than thirty (30) days to provide education and instruction in midwifery or to act as a locum tenens.

Provisional License Application (Student Midwife) - For those who are undertaking the practicum required.

Relicensure Application - For those previously licensed in Wyoming and have failed to timely renew or are seeking to return to active clinical practice.

Reinstatement Application - For those whose license or certificate has been revoked, surrendered, suspended, conditioned, or restricted by the Board and are seeking to have their license reinstated.  

Other Forms

Birth Reporting Form - To report to the board outcomes of all clients for which they have provided services at any point during labor or delivery, within thirty (30) days after each birth. 

Student Midwife Supervision Agreement - To request a new supervisor for a student midwife.

Address / Name Change Form - To request a change in your name or contact information 

Replacement Documents Form - To request replacement license materials 

Verification Request Form - To have your Wyoming license verified to another jurisdiction 

Fingerprint Background Check Instructions - To complete fingerprinting only when notified to do so by the Board office . 

W.S. 7-19-201(a)(xix) requires All persons applying for licensure to the Wyoming Board of Midwifery whose application or other information received by the board indicates that the applicant has or may have been convicted of a crime, and any licensee of the board of midwifery upon written request from the board of midwifery as part of an ongoing investigation of or disciplinary action against the licensee shall provide fingerprint background checks in order to obtain state and national criminal history record information. 

Application processing time is approximately 2-3 weeks after the Board receives all materials to complete your application.  Inquiries regarding these application procedures and application status may be directed to:

Wyoming Board of Midwifery

2001 Capitol Ave, Room 127

Cheyenne WY 82002

(307) 777-3628