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Midwives Forms and Publications

Midwife Licensing Forms

Midwives may apply or renew online and change contact information online.

Midwife Application (PDF)

Newborn Screening Agreement for Newborn Babies of Midwife Clients (PDF)

Midwife Training Certification Form - Newborn Screening Specimen Collection (PDF)

Midwife Notice of Change and Duplicate License Request (PDF)

Request to Executive Director for Expired License Renewal (PDF)

Basic Midwifery Education Course Site Visit Request (PDF)

Basic Midwifery Education Course Reapproval (PDF)

Basic Midwifery Education Course Initial Approval Application (PDF)

Texas Midwifery Manual

Texas Midwifery Basic Information and Instructor Manual (PDF)

Manual Para el Instructor y de Información Básica Sobre Partería de Texas (PDF)

Midwife Practice Forms

Newborn Screening Blood Test Refusal - DSHS (PDF)

Midwives Informed Choice and Disclosure Statement (PDF) **

Midwife Client Consent to Services Provided by Student (PDF)

Declaracion de Opcion Informada y Divulgacion (PDF)

** If you need more space on the Midwives Informed Choice and Disclosure Statement form, please note "see attached" on the form and attach a separate page listing the hospitals to which you might transfer a specific client, and then discuss the information with that client. Please note: this list should not be a generic list of all hospitals in the area – it should be tailored to the planned birth location of each specific and individual midwifery client.

Other Forms

Release of Records Containing Protected Information

Disciplinary Action Questionnaire (PDF)

Criminal History Evaluation Letter

Criminal History Questionnaire (PDF)

Occupational License Application Claiming to Have No Social Security Number

Military Service Member, Military Veteran, or Military Spouse Supplemental Application (PDF)

Expert Witness Application