Before applying for licensure, please familiarize yourself with the general licensing policies.
In order to reinstate a license that has lapsed due to nonrenewal, an applicant must arrange for the submission of the following:
A completed application form and fee of $100.00 in the form of a bank check or money order (no personal checks will be accepted) payable to, Treasurer, State of Connecticut”;
A written summary of professional activities since graduation from nursing school, to include work history, positions, dates, duties, any lapses in active practice as a nurse, and if not currently practicing as a nurse midwife, an explanation of your plans for employment and description of how you intend to refresh your nursing skills; and
A letter submitted directly to this office from the appropriate authority verifying your most recent nursing experience confirming your employment, including dates and evaluation of clinical performance.
Verification of current certification by the American College of Nurse-Midwives (ACNM);
Verification of all RN licenses held, current or expired. Most states utilize the the National Council of State Boards of Nursing's Nursys System to verify licenses electronically. The purpose of the verificaton is to document license history including any disciplinary action taken. Please select this link for a list of Nursys participating states. You may register for verifications from Nursys participating states online.
If you are licensed in a state that does not participate in Nursys, please send the verification form to the state and request that a written verification be sent to this office. Most jurisdictions charge a fee for this service. Please contact the jurisdiction for fee information. .
All supporting documentation should be forwarded directly from the source to:
Connecticut Department of Public Health
Nurse Midwife Licensure
410 Capitol Ave., MS# 12 APP
P.O. Box 340308
Hartford, CT 06134
Fax: (860) 707-1981