Forms

Some of the below forms are available to be filled and submitted via either Google Chrome, Mozilla Firefox or Microsoft Internet Explorer. Please open the form in one of those browsers and submit them online.

eForms:

Address / Name Change

Arizona Statement of Citizenship

Complaint Form

Copy of License / Registration / Renewal Receipt

Records Request (Lists, Labels & Reports)

Notice of Records Transfer

Continuing Education Course Approval

Continuing Education Course Renewal Application

Board Meeting Attendance Request for Continuing Education Credit

 

AttachmentSize
PDF icon Board-Approved Monitor and Evaluator Application305.37 KB
PDF icon Board-Approved Trainer Application282.32 KB
PDF icon Business Entity Registration and Application1.2 MB
PDF icon Continuing Education (CE) Course Renewal Application357.9 KB
PDF icon Continuing Education Course Application with Online Addendum798.19 KB
PDF icon Online Addendum for Course Applications513.72 KB
PDF icon PACE PreCheck Course Submission174.71 KB
PDF icon Extern Application for Preceptorship738.26 KB
PDF icon Inactive/Retired Request Form44.42 KB
PDF icon Application for Licensure by Examination 1.77 MB
PDF icon Application for Licensure by Universal Recognition2.25 MB
PDF icon Application for Licensure by Reciprocity1.96 MB
PDF icon Application for Licensure by Endorsement 1.98 MB
PDF icon Public Records Request42.59 KB
PDF icon Percutaneous Therapy Registration Application 202.03 KB
PDF icon Reinstatement Application665.97 KB
PDF icon Specialty Certificate Application318.13 KB
PDF icon Verification of Licensure in Good Standing45.05 KB
PDF icon Chiropractic Assistant Training Requirements/Application and Sample Course Outline769.24 KB
PDF icon License Verification Request.pdf76.01 KB