Form
Renewals

Your Chiropractic License Expires on December 31st of Each Year. 
Please Read the Following Information Prior to Submitting Your Renewal

 

Paper Renewal Forms

In 2015, the Board moved to an online renewal system allowing licensees to complete their renewal and pay the renewal fee online. With its continued success, paper renewals are no longer available.

Web Browser

Please note that the online renewal portal works best in Google Chrome or Mozilla Firefox. It is recommended that you use one of these browsers to complete the renewal process. 

Desktop/laptop Only

Please use a desktop or laptop to complete the application.  The application does not function properly on a phone or tablet. 

Renewal Receipt Certificate

For your convenience, the last page of the renewal form will be your Renewal Receipt.  To save on printing costs and postage, a paper copy will not be mailed to you. Once you submit your renewal form, an electronic copy of the renewal you submitted will be emailed to the address you provided. The Board will review and process your renewal and a completed copy will be emailed back to you from [email protected] which includes your renewal receipt for your records. The renewal receipt contains your receipt number or confirmation code, the amount paid, your license renewal and expiration dates, license number, license status, and your mailing address. This is to provide you with an immediate copy of your renewal receipt with all the required information.  Please add [email protected] to your contacts or check your spam folder for your renewal receipt. 

Reminder: Pursuant to Arizona Administrative Code (A.A.C.) R4-7-801(M)(1), Each licensee shall complete a minimum of two hours of continuing education in record-keeping for every even-numbered [calendar] year.

NOTICE OF THE LATE FEE:

A licensee will be required to pay the $200.00 late fee for any renewal form and renewal fee not completed and postmarked or received by 12:00 a.m. Arizona Time on January 1, 2022.

Important information regarding submission of your renewal fee by credit or debit card via the payment portal: 

In order to avoid a $200.00 late fee assessment and the ADMINISTRATIVE SUSPENSION of your license, you must return to the renewal form to sign it after submitting your renewal fee via the payment portal.

Please note that when the renewal form is complete the following blue "Click to Sign" button 

will appear at the bottom of your screen to allow for submission. 

Once your renewal form has been successfully submitted the following screen will appear.

If you do not see this screen below then your renewal was not submitted and resubmission is required.

Once your renewal is processed, your renewal receipt is emailed from EchoSign to the address from your renewal form.  Check your spam/junk folder if you have not already allowed [email protected] to email you.

We strongly recommend that you read and understand all the above information prior to completing the online renewal to ensure a smooth and successful process.

Click here to renew your 2022 license.

 

Attachment

Renewals Notice

Supplemental Continuing Education Coursework Form.pdf