Forms and Reports to be Completed by an LCPM
Annual Report - Pursuant to KRS 314.404(10) and 201 KAR 20:660, an LCPM shall report the following information to the Board of Nursing on or before September 1 of each year for the period of July 1 through June 30 preceding. The LCPM Advisory Council shall review all reports.
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.
Locate the following forms at the link below:
LCPM Informed Refusal Form
Online Validation
Review your application or licensure status
How to File a Self-Complaint or Complaint Regarding the Actions of an LCPM
Disciplinary Monitoring
Additional Resources