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:
Applications are only accepted online. In order to submit your reinstatement application online, you will need to know your current user ID and password in DPH's system. If you do not recall your user ID and password, you can use the recovery options as well as the 'Register' link. If you use the 'Register' link, please disregard the language under 'PLEASE READ' and select 'NEXT' button at the bottom of the page. On the next screen, you will need to match your first name, last name and the last 4 digits of your SSN and create a new password and validate your email address. Please select this link to submit your online application.
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