Licensed Certified Professional Midwives

Annual Report - Pursuant to KRS 314.404(10) and 201 KAR 20:660, an LCPM shall file with the KBN an annual report on or before September 1 of each year for the period of July 1​ through June 30 preceding.

Incident Form - Under Kentucky Law, KRS 314.404(11) and 201 KAR 20:660, Licensed Certified Professional Midwives (LCPM) must submit the incident form to the Board of Nursing within thirty (30) days of the occurrence of a case of newborn or maternal death attended by the LCPM at the discovery of death.

Document Upload - Upload documents or view documents already uploaded.

Fee Payment Update: Effective July 6, 2020, fees assessed by the banking industry will be charged for each transaction. Payments made with a credit card will have an additional 2.75% of the payment added to the total. Payments made by ACH (online check) will have a $1.00 charge attached to the payment. The banking fees will be in addition to the fees due the Kentucky Board of Nursing.

Applications and documents are reviewed within 14 days. However, if you respond "Yes" to the disciplinary or conviction questions it can take up to 3 months for processing your application.

Requirements for initial licensure: 


Additional resources are provided below.

Instructions for completing the online application 

Practice and the LCPM regulations

KBN Investigation and Discipline Process applicable to LCPM's

LCPM Incident form 

Informed Refusal form​ 


See Also...

Use this form if you have a legal name change.

Use this form if have an address change

Use this link to access frequently asked questions.

For questions or comments regarding LCPM licensure, contact Suha Qattan-Walsh, Reinstatement, DT, SANE & LCPM Coordinator at 502-403-8084 or toll-free at 1-800-305-2042​ or use LCPM Contact Form​.​​