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

Chiropratic Assistant Registration Form

Continuing Education Course Application

Continuing Education Course Renewal Application

Continuing Education Course Online Addendum

Complaint Form

Copy of License / Registration / Renewal Receipt

Records Request (Lists, Labels & Reports)

Notice of Records Transfer

AttachmentSize
PDF icon Address / Name Change458.62 KB
PDF icon Arizona Statement of Citizenship or Alien Status144.84 KB
PDF icon Board Approved Evaluator Application438.43 KB
PDF icon Board Meeting Attendance Request 205.3 KB
PDF icon Business Entity Registration and Application1 MB
PDF icon Chiropractic Assistant Notification of Hire / Termination (Employment)2.5 MB
PDF icon Chiropractic Assistant Training Requirements/Application and Sample Course Outline503.31 KB
PDF icon Continuing Education Renewal Application475.97 KB
PDF icon Continuing Education Application with Online Addendum723.84 KB
PDF icon Extern Application for Preceptorship820.61 KB
PDF icon Inactive Chiropractic Licensing Application508.34 KB
PDF icon Jurisprudence Exam Request (Board-Ordered)280.08 KB
PDF icon Licensure by Endorsement Application1.43 MB
PDF icon Licensure by Examination Application1.46 MB
PDF icon Licensure by Reciprocity Application1.63 MB
PDF icon Online Addendum for Course Applications458.07 KB
PDF icon Public Records Request260.71 KB
PDF icon Percutaneous Therapy Registration Application 202.03 KB
PDF icon Reinstatement Application665.97 KB
PDF icon Retirement Status Application958.39 KB
PDF icon Specialty Application696.98 KB
PDF icon Verification of Licensure in Good Standing67.2 KB
PDF icon Verification Request Form248.8 KB