Important Forms for Midwives
Applications may be emailed to JUA@WendyGordonConsulting.com or faxed to (425) 536-8221.
Frequently Used Forms
Use this form to apply for JUA coverage if you are a Licensed Midwife or Certified Nurse-Midwife in Washington State.
Use this form to apply for JUA coverage if you are the owner of a Licensed Freestanding Birth Center in Washington State.
Use this form for a non-JUA-insured midwife acting as locum for a JUA-insured midwife.
Do not email incident reports. Either fax them or upload to this secure portal.
Use this form when you are canceling your policy and need to report the number of primary births that you performed this year .
Payment Authorization Forms
Payment authorization forms may be uploaded to the secure portal. For your own protection, please do not email your bank or credit card information unless you have encrypted email.
For automatic bank transfers (monthly payments only)
Transaction fees: 1.5% for debit, 2.4% for credit
Relevant Links for Midwives & Birth Centers
Need to renew your license? Can’t find the legend drugs & devices? Not sure where else you should report an incident? We’ve got you covered.
Licensing & Regulatory Agencies
- Washington Dept of Health (DOH) – Midwife
Apply for, renew, or manage your midwifery license - Washington Dept of Health (DOH) – Birth Center
Guidance and resources for licensed freestanding birth centers in WA - DOH Credential Lookup
Verify licensure status for midwives and other healthcare providers
Laws, Rules & Scope of Practice
- RCW 18.50 – Midwifery Statutes
The legal statute authorizing midwifery in Washington State - WAC 246-834 – Licensed Midwives
State administrative rules that govern licensed midwifery practice - RCW 18.46 – Birth Center Statutes
Legal statute authorizing freestanding birth centers in Washington - WAC 246-329 – Birth Centers
Rules governing licensing and operations of freestanding birth centers
Required Reporting of Incidents
- JUA – What to Report
List of incidents that should be reported to the JUA - MAWS QMP – Incident Review
What to report and how to report it for MAWS members - WARM – Incident Review Request Form
What to report and how to report it for WARM members - DOH – What to Report for Birth Centers
Rules governing adverse health event reporting for licensed birth centers
Quality Improvement & Hospital Collaboration
- Smooth Transitions
Resources for midwives, EMS and hospitals for improving transfers - Washington State Perinatal Collaborative
Statewide initiative working to improve perinatal health in WA