Occasionally NARM receives requests for listings of CPMs in specific areas. While NARM will verify that a midwife is a CPM if asked, we cannot release names or any other information without prior authorization. If you would like this information released, please print and sign the form below and mail to:
PO Box 429
Summertown TN 38483
I, (print/type name)____________________________________ give permission for NARM to release my name as a CPM, including contact information, CPM number, CPM issue date, and CPM expiration date. This becomes effective on (date)___________________. I understand that to revoke this permission, I must send notice in writing to the same address.
Current city, state, zip: ____________________________________________
Current phone: __________________
Current e-mail (if available): _____________________________
Current status: ___ legally recognized (licensed, registered) by state, or___ no legal recognition by state