Condensed application instructions with the requirements for a permit
or a certificate are in the front of each application packet. For additional information,
including education and experience requirements, you may review the statutes and
We will accept a fax, e-mail, or written notice that comes directly from the licensee or
applicant. We cannot accept a telephone call for a change of address. Board mailing
address: P.O. Box 110806, Juneau, AK 99811-0806; Fax: (907) 465-2974 or e-mail:
firstname.lastname@example.org If you would like to receive a license you must submit a change of
address form and the required fee payable to the State of Alaska.
To change your name, mail an original Certified True Copy of the legal document that
reflects the name change OR download the Name Change Affidavit form from our web site
(a copy of the legal document must accompany the change). The required fee is payable
to the State of Alaska and must accompany the name change request. Board mailing
address: P.O. Box 110806, Juneau, AK 99811-0806.
To obtain a Certified True Copy, take the original document and a photocopy to a notary
public so he/she may compare the original to the photocopy of the document. Either the
applicant or the notary must write, “I certify this to be a true copy of the original document”
on the photocopy and attest to that fact by signing the document and having it notarized.
Mail a written request to the Board of Certified Direct Entry Midwives. P.O. Box 110806,
Juneau, AK 99811-0806 along with a $20.00 money order or check made payable to the
State of Alaska. Allow three weeks processing time from the date we receive your request.
Visit the Applications & Forms Page.
No. Scanned or faxed documents are not acceptable.
Yes, licensing records are public documents and available to members of the public upon
written request and payment of copying fees. Information considered confidential and not
releasable to the general public include social security numbers and other information
considered confidential by state or federal law. Your address of record is public information
and is displayed on the division’s internet licensing search program. Licensees have
expressed concern that their address is so readily available. Some licensees have elected to
have a post office box or practice location for their official address of record to avoid
having their residential address easily accessible. Please be advised that all notices from the
Board (renewal notices, licenses, and other legal documents) will be mailed to the address
of record provided.
All licenses issued by the Board of Certified Direct Entry Midwives expire on December 31st of
even-numbered years regardless of when issued, except new licenses issued within 90 days
of the expiration date will be issued to the next biennium.
No. Licensees who received a permanent license within one year of the current expiration
date do have to renew but will pay only one-half of the renewal fee.
Renewal notices are mailed at least 30 days before the expiration date to the address we
have on file for you. If you have a change of address, don’t wait until the last minute to give
us that information, otherwise, your renewal notice may be delayed in getting to you. Failure
to receive a renewal notice does not relieve a licensee from the responsibility of renewing a
license on time.
Plan 4 to 6 weeks for the application process for a Certified Direct Entry Midwife. You can
avoid delays by making sure you follow the directions and complete the application
correctly. You must submit the correct fees and supporting documentation in the proper
format. Source documents must come directly from the providers. In order for your
application to be scheduled for review by the board at its next regularly scheduled meeting,
a complete application for certification and all supporting documents, must be received by
the division’s Juneau office at least 30 days before the date of the next regularly scheduled
meeting of the board.
Please send your questions to email@example.com