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
| Attachment | Size |
|---|---|
 Address / Name Change | 458.62 KB |
| Board Approved Evaluator Application | 246.17 KB |
| Board Approved Trainer Application | 250.47 KB |
| Board Meeting Attendance Request | 42.39 KB |
| Business Entity Registration and Application | 1.2 MB |
| Continuing Education Renewal Application | 475.97 KB |
| Continuing Education Application with Online Addendum | 723.84 KB |
| Extern Application for Preceptorship | 738.26 KB |
| Inactive / Retired Request | 215.6 KB |
| Licensure by Endorsement Application | 1.43 MB |
| Licensure by Examination Application | 1.46 MB |
| Licensure by Reciprocity Application | 1.63 MB |
| Online Addendum for Course Applications | 458.07 KB |
| 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 |
| Verification Request Form | 42.28 KB |
| Chiropractic Assistant Training Requirements/Application and Sample Course Outline | 769.24 KB |
