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Board Forms

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

Arizona Statement of Citizenship

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State of Arizona Statement of Citizenship form is required for all new applications. Arizona Revised Statutes § 41-1080 requires, in general, that a person applying for a license must submit documentation to the licensing agency that satisfactorily demonstrates that the applicant’s presence in the United States is authorized under federal law.

Board-Approved Monitor and Evaluator Application

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The State of Arizona Board of Chiropractic Examiners welcomes your interest in becoming a Board Approved consultant. Please read the Board's basic criteria and specific credentials and the required evaluation listed on the Board's Approved Consultants tab before submitting your application. You must meet the required criteria listed for your specific discipline to be approved by the Board. To apply for approval, please complete the application below and submit the requested supporting documents. 

Board-Approved Trainer Application

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If you wish to be able to provide Board Ordered Training to licensees subject to non-disciplinary or disciplinary action, please use the Approved Trainer for Board Ordered Education listed below.  The Board is seeking training in the following areas:  ethics, billing, x-ray imaging, AZ Jurisprudence, record keeping, history, diagnostic procedures, and evaluation/management. Please review the necessary instructor and training criteria included in the application. 

Continuing Education - PACE PreCheck Course Application

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The State of Arizona Board of Chiropractic Examiners accepts PACE recognition as satisfying the Board's requirements for the Continuing Education process. However, courses must still be individually approved by the Board. The Board will NOT approve courses in which the primary focus is the promotion of a product or service or courses that require participants to purchase a product or service. Each course shall be on subjects of CLINICAL BENEFIT TO THE CONSUMER OF CHIROPRACTIC SERVICE. The course must have a significant relationship to assessing, diagnosing, or treating patients within the

Continuing Education Application Check Log

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Please submit the CE Application Check Log with your single check payment to the Board for your electronically submitted Continuing Education Applications. The Board no longer accepts handwritten applications or applications submitted through the mail. Please note if the Board does not receive payment within ten days of receiving your application. Your application will be canceled, and you must resubmit the entire application packet. 

Continuing Education Course Application with Online Addendum

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The Arizona State Board of Chiropractic Examiners welcomes your interest in providing continuing education for Arizona licensees. Please read the following forms, laws, and rules carefully before submitting your application, as the Board cannot refund application fees, even if you do not qualify for approval. The Board will NOT approve courses in which the primary focus is the promotion of a product or service or courses that require participants to purchase a product or service. Each course shall be on subjects of CLINICAL BENEFIT TO THE CONSUMER OF CHIROPRACTIC SERVICE. The course must have