Ariz. Admin. Code § R9-16-102 - Application for an Initial License
A. An applicant for an initial license to
practice midwifery shall submit: 8.
7. Except as provided in subsection (B), a
non-refundable application fee of $25; and
9.
8. A non-refundable
testing fee of $100 for a jurisprudence test administered by the
Department.
1. An
application in a format provided by the Department that contains:
a. The applicant's name, address, telephone
number, and e-mail address;
b. The
applicant's Social Security Number, as required under A.R.S. §§
25-320 and
25-502;
c. Whether the applicant has ever been
convicted of a felony or a misdemeanor in this or another state or
jurisdiction;
d. If the applicant
was convicted of a felony or misdemeanor:
i.
The date of the conviction,
ii. The
state or jurisdiction of the conviction,
iii. An explanation of the crime of which the
applicant was convicted, and
iv.
The disposition of the case;
e. Whether the applicant agrees to allow the
Department to submit supplemental requests for information under
R9-16-107(C)(2)
;
f. An attestation that
information required as part of the application is true and accurate;
and
g. The applicant's signature
and date of signature;
2. A copy of the
applicant's:
a. U.S. passport, current or
expired;
b. Birth
certificate;
c. Naturalization documents;
or
d. Documentation of legal resident
alien status;
2. Documentation for the applicant that
complies with A.R.S. §
41-1080;
3. Documentation that demonstrates the
applicant is 21 years of age or older if the documentation submitted in
subsection (A)(2) does not demonstrate that the applicant is 21 years of age or
older;
4. Current documentation of
completion of training in:
a. Adult basic
cardiopulmonary resuscitation through a course recognized by the American Heart
Association, and
b. Neonatal
resuscitation through a course recognized by the American Academy of Pediatrics
or American Heart Association;
5. Documentation of a high school diploma, a
high school equivalency diploma, an associate degree, or a higher
degree;
6. Documentation that the
applicant is certified by the North American Registry of Midwives as a
Certified Professional Midwife;
7. A current photograph of the
applicant;
B. An
applicant is not required to submit the fee in subsection (A)(7) or (E)(1) if
the applicant, as part of the application in subsection (A), submits an
attestation that the applicant meets the criteria for waiver of licensing fees
in A.R.S. §
41-1080.01.
1. Shall take the
jurisprudence test administered by the Department,
2. Shall provide proof of identity by a
government-issued photographic identification card upon the request of the
individual administering the jurisprudence test,
3. May take the jurisprudence test as many
times as desired, within 180 calendar days after the date of the notification,
without paying an additional testing fee, and
4. Shall score 80% or higher correct answers
on the jurisprudence test to be eligible to receive an initial license to
practice midwifery.
1. Except as provided in subsection (B), a
licensing fee of $25; and
2. The
documentation required in subsection (A)(4) or (6), if the documentation of
training required in subsection(A)(4) or certification required in subsection
(A)(6) is not current.
1. Score 80% or
higher correct answers on the jurisprudence test within 180 calendar days after
the date of the notification of eligibility to take the jurisprudence test,
or
2. Submit to the Department the
applicable documentation and licensing fee required in subsection (D) within
120 calendar days after the date of the notification in subsection
(D).
Notes
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