Section R9-16-102. Application for Initial Licensure

A.      An applicant for an initial license to practice midwifery shall submit:

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 misde- meanor:

i.         The date of the conviction,

ii.        The state or jurisdiction of the conviction,

iii.      An explanation of the crime of which the appli- cant was convicted, and

iv.       The disposition of the case;

e.         Whether the applicant agrees to allow the Depart- ment to submit supplemental requests for informa- tion under R9-16-107(C)(2);

f.         An attestation that information required as part of the application has been submitted and 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;

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 Associa- tion, and

b.        Neonatal resuscitation through a course recognized by the American Academy of Pediatrics or Ameri- can 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 Profes- sional Midwife;

7.        A current photograph of the applicant;

8.        A non-refundable application fee of $25; and

9.        A non-refundable testing fee of $100 for a jurisprudence test administered by the Department.

B.       The Department shall review an application for an initial license to practice midwifery according to R9-16-107 and Table 1.1.

C.      If an applicant receives notification of eligibility to take the jurisprudence test, the applicant:

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 without paying an additional testing fee, and

4.        Shall score 80% or higher correct answers on the juris- prudence test to be eligible to receive an initial license to practice midwifery.

D.      If an applicant scores 80% or higher correct answers on the jurisprudence test, the Department shall provide written notice to the applicant, within five working days after the date of the jurisprudence test, to submit to the Department:

1.        A licensing fee of $25; and

2.        The documentation required in subsection (A)(4) or (6), if the training required in subsection(A)(4) or certifica- tion required in subsection (A)(6) is not current.

E.       The Department shall issue an initial license to practice mid- wifery within five working days after receiving the applicable documentation and licensing fee required in subsection (D).

F.       The Department shall provide to an applicant a written notice of denial that complies with A.R.S. § 41-1092.03(A) and inform the applicant that the applicant may reapply under sub- section (A) if the applicant does not:

1.        Score 80% or higher correct answers on the jurisprudence test within 180 calendar days after the date of the notifi- cation 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 subsec- tion (D).

Historical Note

Section repealed, new Section adopted effective March 14, 1994 (Supp. 94-1). Amended by final rulemaking at 8

A.A.R. 2896, effective June 18, 2002 (Supp. 02-2). Sec- tion R9-16-102 repealed; new Section R9-16-102 renum-

bered from R9-16-103 and amended by exempt rulemaking at 19 A.A.R. 1805, effective July 1, 2013

(Supp. 13-2).