Form - FORMS (18VAC85-130)

Current through Register Vol. 40, No. 22, June 17, 2024

Form - FORMS (18VAC85-130)

Instructions for Completing a Licensed Midwife Application (rev. 3/2017)

Form A, Claims History (rev. 11/2010)

Form B Supplemental Form (rev. 9/2018)

Form C, Jurisdiction Clearance (rev. 11/2010)

Instructions and Application for Reinstatement of a License to Practice as a Certified Professional Midwife (CPM) (rev. 4/2018)

Application to Reactivate an Inactive License for a Licensed Midwife (rev. 5/2019)

License Verification Request (rev. 2/2024)

Amended, Virginia Register Volume 40, Issue 16, eff. 4/24/2024.