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:
Arizona Statement of Citizenship
Copy of License / Registration / Renewal Receipt
Records Request (Lists, Labels & Reports)
Continuing Education Course Approval
Board Meeting Attendance Request for Continuing Education Credit
| Attachment | Size |
|---|---|
 Board-Approved Monitor and Evaluator Application | 305.37 KB |
| Board-Approved Trainer Application | 282.32 KB |
| Business Entity Registration and Application | 1.2 MB |
| Continuing Education (CE) Course Renewal Application | 357.9 KB |
| Continuing Education Course Application with Online Addendum | 798.19 KB |
| Online Addendum for Course Applications | 513.72 KB |
| PACE PreCheck Course Submission | 174.71 KB |
| Extern Application for Preceptorship | 738.26 KB |
| Inactive / Retired Request | 215.6 KB |
| Licensure By Examination Packet | 1.54 MB |
| Licensure By Endorsement Packet | 1.96 MB |
| Licensure By Universal Recognition Packet | 2.01 MB |
| Public Records Request | 42.59 KB |
| Percutaneous Therapy Registration Application | 202.03 KB |
| Reinstatement Application | 665.97 KB |
| Specialty Certificate Application | 318.13 KB |
| Verification of Licensure in Good Standing | 45.05 KB |
| Chiropractic Assistant Training Requirements/Application and Sample Course Outline | 769.24 KB |
| License Verification Request.pdf | 76.01 KB |
