Ariz. Admin. Code § R9-16-103 - License Renewal
A. At least 30
calendar days and no more than 60 calendar days before the expiration date of a
midwifery license, a midwife shall submit to the Department:
1. An application for renewal of a midwifery
license, in a format provided by the Department, that contains:
a. The midwife's name, address, telephone
number, and e-mail address;
b. The
midwife's license number;
c.
Whether the midwife has been convicted of a felony or a misdemeanor in this or
another state or jurisdiction in the previous two years;
d. If the midwife 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
midwife was convicted, and
iv. The
disposition of the case;
e. Whether the midwife agrees to allow the
Department to submit supplemental requests for information under
R9-16-107(C)(2)
;
f. An attestation that the
midwife has completed the continuing education requirement in
R9-16-105 ;
g. An attestation that the midwife is
complying with the requirements in A.R.S. §
32-3211;
h. An attestation that information required
as part of the application is true and accurate; and
i. The midwife's signature and date of
signature;
2. Either:
a. Documentation that the midwife is
currently certified by the North American Registry of Midwives as a Certified
Professional Midwife; or
b. For a
midwife who has been continuously licensed as a midwife by the Department since
1999, a copy of both sides of documentation showing the completion of current
training in:
i. Adult basic cardiopulmonary
resuscitation that meets the requirements in
R9-16-102(A)(4)(a),
and
ii. Neonatal resuscitation that
meets the requirements in
R9-16-102(A)(4)(b)
; and
3. A
non-refundable renewal fee of $25.
B. The Department shall review an application
for renewal of a license to practice midwifery according to
R9-16-107 and Table 1.
Notes
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