Forms

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Address Change - Notification of address change. 

Arizona Statement of Citizenship or Alien Status

Board Approved Chiropractic Assistant Training Programs- List of approved providers of chiropractic assistant training.

Chiropractic Assistant Notification of Hire -Form for notifying the Board of a newly hired chiropractic assistant.

Chiropractic Assistant Notification of Termination - Form for notifying the Board of a terminated chiropractic assistant.

Chiropractic Assistant Registration -Instructions and form for registering any chiropractic assistants.

Chiropractic Assistant Training Requirements/Application and Sample Course Outline -Application to provide chiropractic assistant training.

Chiropractic Assistant Transfer Form - Form for transferring an assistant to a new doctor.

Chiropractic Licensing Information - General information regarding chiropractic licensing requirements in Arizona.  Includes a form to request applications for chiropractic licensure and certification in physiotherapy and acupuncture.

Complaint Form - Instructions and form to issue a complaint against a chiropractor.

Continuing Education Application - Application for approval to provide a continuing education course.

Extern Application - Application for students for the preceptorship program. 

Inactive Chiropractic Licensing Application - Application for requesting inactive status for a active chiropractic license and related laws.

Jurisprudence Exam Request (Board-Ordered) - Form to request to take the jurisprudence examination as a condition of a Board Order.

List of Reportable Criminal Charges and Arrests - Categories and types of misdemeanor offenses that have been determined to affect patient safety and are reportable under A.R.S. § 32-3208 by a licensee or license applicant.

Public Records Request - Form to request to view or receive copies of public records.

Records Request - Form to request agendas, minutes, mailing labels, lists, etc.

 Reinstatement Application -  Application to reinstate a license.  Laws governing reinstatement.

Reinstatement from Inactive to Active - Application to reinstate from an inactive to an active license.

Retirement Status Application - Application for retirement status for licensed chiropractors.

Request for Approval of Board Ordered CE- Form to have staff pre-approve Board ordered continuing education. NOT to be used for approval of continuing education for renewal.

Specialty Applications - Application for certification in acupuncture and physical medicine modalities and therapeutic procedures.

Verification of Licensure in Good Standing - Form to verify license status.

Verification Request Form - Form to request verification of licensure.