Form
Renewals

Board Staff has until February 2, 2023, to review and process all applications.

Renewal Applications received after January 3, 2023, are required to pay a $200 Late Fee. 
 

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

Continuing Education Requirements

You are required to complete 12 hours of continuing education. Board Statute and Rules require it to be in the topics listed in sections §32-922, subsection B, and section §32-922.02.  When renewing your license in even-numbered calendar years, you must complete 2 hours of continuing education in documentation and record keeping per A.A.C. R4-7-801(M)(1). Board-approved Continuing Education courses can be found on the Board’s website under the Continuing Education tab. 

Renewal Application and Payment 

The Renewal process is a two-part process. You must submit your payment ($225.00) and your application before the expiration date. Failure to complete either item may result in a late application or your license being placed on administrative suspension.

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.  Paper renewals are no longer mailed to the licensee's address of record.  You may download a PDF version of the Renewal Application and mail it to the Board's office with a check or money order. 

Retired or Inactive Status

If you wish to make your license Inactive or Retired, you must complete the Inactive Retired Form and submit it to the Board for processing in addition to your Renewal Application. To become Inactive or Retired, your license must be in good standing and have no current disciplinary action. You can verify your license status on the Board "Find a Chiropractor" website to help determine if you need to submit an Inactive/Retired Form.

If your license is already in Retired status, to maintain your Retired Status with the Board, you are required to submit a Renewal Application annually. The Renewal Fee and Continuing Education hours are waived. Please use the link for the ONLINE APP below to access the online application.  If your license is Retired, you are not eligible to engage in the practice of chiropractic in the State of Arizona. 

If your license is Inactive,  you must complete a renewal application to maintain your Inactive status. You are required to submit a Renewal Application and pay the Annual Renewal Fee. The hours needed for continuing education are waived while your license is Inactive. If your license is Inactive, you are not eligible to engage in the practice of chiropractic in the State of Arizona. 

Essential Steps for Successful Submission: 

STEP ONE: When you are ready to proceed, click on the 2023 Renewal Application link at the bottom of this page. This link will take you to the credit card payment screen. Enter the required information, including your license number, and hit the “Pay Now” button.

STEP TWO:  After making your credit card payment, click CONTINUE to step two, which includes a link to “Complete Online Renewal.” The Online Renewal form will open in Adobe Sign and allow online submission. This is an ONLINE-ONLY APPLICATION. You can not download or save it and complete it from your computer. If you do not complete the entire application and submit it by selecting CLICK to SIGN, the application will time out, and you will need to start the application over.

    STEP THREE: Once you have completed all the required fields for the application, this is when the renewal form is complete. The "Click to Sign" button will appear at the bottom of your screen to allow submission. The “Click to Sign” button will not appear unless all the required fields have been completed. There is a count of required fields in the upper right-hand of the form. Please hover over the number; it will show you what fields you missed.

    Once your renewal form has been successfully submitted, the following screen will appear. If you do not see this screen below, your renewal application was not successfully submitted, and resubmission is required.

    STEP FOUR: When you submit your renewal application, you'll receive an email copy of your renewal application from [email protected]. The renewal application will be emailed to the address you provided. Keep this electronic copy for your records to verify that you submitted your renewal to the Board. This document will serve as a certificate in good standing until the Board staff processes your renewal and emails your final renewal certificate.

    STEP FIVE: Board staff will review and process your application. Applications are processed in the order they are received. Board staff has until January 25th of each year to send out Administrative Suspension Notices and until February 2nd of each year to process all applications. 

    STEP SIX: Once the Board staff has reviewed and processed your renewal application, you will receive an email from [email protected], which includes your completed, signed renewal receipt and a copy of your renewal application. The renewal receipt contains your receipt number or confirmation code, the amount paid, your license renewal and expiration date, license number, license status, and your practice address. 

    Once your renewal is processed, your renewal receipt is emailed from EchoSign to the address from your renewal form.  Check your spam/junk folder for an email from [email protected]

      Renewal Receipt Certificate

      The Board staff will review and process your renewal, and a completed copy will be emailed back to you from [email protected], which includes the signed 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 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.

      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, postmarked, or received by midnight Arizona Time on January 3, 2023.

      You must submit your renewal application and payment to avoid a $200.00 late fee assessment and the possible ADMINISTRATIVE SUSPENSION of your license. If you do not complete both, your application will not be processed, and your license can be placed on ADMINISTRATIVE SUSPENSION. You are responsible for verifying that you received a copy of your renewal application from [email protected]. If your license is on ADMINISTRATIVE SUSPENSION, you can not treat patients until your license is restored to ACTIVE.

      Helpful hints for completing the renewal application: 

      1. Watch the required fields-there is a count of required fields in the upper right-hand corner of the form. You will not be able to submit your renewal application until you have completed all the required fields. 
      2. The form cannot be downloaded to your computer or saved. It must be completed and submitted online. 
      3. If the application times out, you will have to start over and reenter all your information. 
      4. Your name, phone number, and payment authorization code will import from your payment data keyed in STEP ONE. 
      5. Add [email protected] to your email contacts to ensure you receive your renewal submission receipt and the completed, signed renewal certificate.
      6. If you are submitted a Retired Renewal Application, please use the Online App or Print PDF the link below to bypass the payment portal.

      Applications 

      2023 Renewal Link Payment and Application 

      If you made your credit card payment but exited the screen without clicking on the Online Renewal Application, use the link below to access the Online Renewal Application without going through the payment portal.  If you are Retired and submitting your renewal without payment, please use either the Online Renewal Application or select the PRINT PDF and mail your application. 

      2023 Online Renewal Application  

      To print and mail your renewal with a check or money order, download and print the 2023 Renewal Application. Your payment and application must be postmarked by December 31, 2022.  

      2023 PDF Renewal Application

      Reinstatement Application

      If your license is on Administrative Suspension and you wish to reinstate your license back to Active status, you will need to download and complete the Reinstatement Application and pay the necessary processing fees. Please thoroughly review the application before submitting it to the Board.

      If your license is on Inactive or Retired status and you wish to reinstate your license to Active status, you will need to complete the Reinstatement Application and submit the necessary continuing education and pay the required reinstatement fees. There may be additional steps required to complete your Reinstatement Application, and it may be required to be reviewed by the Board. 

      Reinstatement Application