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Wisconsin DHS

For more information on COVID-19 please click here for a link to the Wisconsin Department of Health Services.

PRACTICE ACT

Pursuant to 2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record. To apply for a predetermination, please fill out Form 3085 and submit all required documentation specified on the form. Pursuant to Wis. Stat. § 111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.

License Information

Fee Reduction

Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee.  Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website prior to submitting Form 3217.

Per Wis. Stat. § 440.08(2), the required renewal date for the Athletic Trainer credential is 06/30/even years.  Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.

Requirements


Pre-Credential Education Information

At least a bachelor's degree from an accredited college or university is required.

Application for Licensure

Form Description
2496 Application For License To Practice As An Athletic Trainer
3217 ​Application for Fee Reduction (This form must accompany the application for the credential)
2517 Evaluation and Treatment Protocol Form (This form is to be completed by a consulting physician)
2497 Request For Verification of Certification
​2829 Malpractice Suits or Claims Form (if applicable)
3085 ​Application for Predetermination (Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal, state, or local law, including municipal ordinances, in this state or any other)
2252 ​Convictions and Pending Charges
3071 ​Fax Payment Form

Renewal Information

Requirements

  • FEE (See Renewal Dates and Fees)
  • SIG (Signature regarding the completion of Continuing Education, included in on-line renewal and paper form see Continuing Education Information for details)
  • CPR (Current CPR/AED certification is required)
  • INS (Malpractice liability insurance is required. If renewing via paper form, you must also submit Form 2543.)
  • WHD (Work History is requested. If renewing via paper form, you must also submit Form 2543.)
  • EPF (Evaluation and Treatment Protocol Form 2517 is to be completed by the supervising physician and filed at the place of employment. If renewing via paper form, you must also submit Form 2543.)
  • If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at (608) 266-2112 or [email protected].

Renewal Methods

Form Description
RDAF Renewal Dates and Fees
R210 Active Duty/Discharge Renewal Extension
2543 ​Additional Requirements for Renewal
​2517 ​Evaluation and Treatment Protocol

Wisconsin Act 210 (effective June 1, 2012)

This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.

This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.

Service members and spouses may request extensions of licenses beyond 180 days from discharge and may request a waiver or extension of time to complete continuing education requirements due to hardship. Please view Active Duty/Discharge Renewal Extensio​n Form R210 for further information.


Go4Ellis Per Diem Work

Hello ATs,

It is an understatement to say that we are living in unprecedented times. ATs are facing tough challenges on a scale greater than many have experienced in their lifetime. As I speak with members throughout the country, I’m reminded of how incredibly resilient we are, how we are natural problem solvers and are willing to go above and beyond for the health and well-being of those in our care. The tireless response to this crisis by members across the globe makes me so very proud to be an athletic trainer.

This year's NATM theme “ATs Impact Health Care Through Action” has never been more applicable than now, during the COVID-19 pandemic. Hospitals across the country are stressed and demand for more beds, added medical facilities and staffing is at an all-time high. We can help.

Global recommendations and efforts to contain the virus inadvertently leave the country with thousands of available qualified athletic trainers who are educated, trained and willing to help through this unprecedented time.

NATA and Go4Ellis, a mobile per-diem job platform, have joined forces to connect thousands of athletic trainers with understaffed hospitals and health care organizations throughout the United States during the COVID-19 pandemic. The portal was originally designed to provide sporting/local events with appropriate health care for youth athletes; however, in light of the current health care needs, it has been modified to support hospital systems and health care organizations in need of COVID-19 support.

As athletic trainers, we are skilled in the full continuum of care, from prevention and diagnosis to rehabilittion. We work alongside physicians in a host of industries – sports, higher education, military, clinical, occupational health, performing arts and public service. Our skills are not based on any specific industry, but rather an understanding of health care. Many of our members have already joined their peers in the clinical setting to support with testing, transport and documentation. We are proud to have a partner in Go4Ellis that quickly and easily connects those in need of help with athletic trainers who are ready to serve.

Thrive on,

Tory Lindley, NATA President

For WI ATs looking for per diem work, the Go4Ellis app can be downloaded through the AppStore and Google Play. Or head to the Go4Ellis website at www.go4ellis.com for more information.

Here is a link to the app in the app store: https://apps.apple.com/us/app/go4ellis/id1186370661

Here is a link to the app in the Google Play Store: https://play.google.com/store/apps/details?id=com.go4ellis&hl=en_US