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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Respiratory Care - 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.




Application Packet
(this includes request for temporary certificate)

Form #
Title
Application Information Form (Department information)
Instructions to Applicants For Respiratory Care Licensure

Application For Licensure to Practice Respiratory Care

Verification of Certification (This form needs to be completed and forwarded to the National Board for Respiratory Care Inc , NBRC.)
Respiratory Care Practitioner Certificate of Professional Education
Practice of Respiratory Care (This form is not required for new graduates)
Temporary Certificate Request for Respiratory Care Practitioner
Wisconsin Statues and Rules Exam (This is required to take the online exam.)
Convictions and Pending Charges
Notices (Department Information)