State of Wisconsin Department of Regulation & Licensing
Ensuring the availability of safe and competent professional services 		Secretary Celia Jackson
 Secretary Jackson
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Physician - Temporary Application Forms

Petitions for refunds must be in writing and may be granted only if the criteria set forth in Wis. Admin. Code s. RL 4.06 are met.

Physician (MD/DO) Temporary Educational Permit Application Packet

Form #
Title
Application Information Form
Application For Temporary Educational Permit
Affidavit of Hospital Authority
This is required to take the open book exam.
 Application for Renewal of Temporary Educational Permit (This form is only required when you are renewing an existing TEP.)
Convictions and Pending Charges
Notices (Department Information)