Chiropractic Physician Application Instructions File
This file includes instructions for chiropractic physician licensure application through endorsement, acceptance of examination, restoration, and more. To avoid delays, follow the provided guidelines carefully. The application is valid for 3 years from the submission date.
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How do I fill this out?
Follow the instructions carefully to ensure a smooth application process. Make sure to complete all necessary documents and translations accurately. Submit all required supporting documentation and fees as directed.
How to fill out the Chiropractic Physician Application Instructions File?
1
Complete the four-page Application for Licensure/Examination.
2
Submit translations for documents in foreign languages.
3
Direct requests for assistance to the given telephone number.
4
Fill in all necessary personal information, education, and history details.
5
Sign and date the certifying statement.
Who needs the Chiropractic Physician Application Instructions File?
1
Chiropractic graduates seeking licensure through endorsement.
2
Applicants aiming to restore a lapsed chiropractic license.
3
Foreign-trained chiropractors needing an official translation of their documents.
4
Visiting professors applying for a temporary license in the U.S.
5
Chiropractors transferring their National Board of Chiropractic Examiners Examination scores.
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What are the instructions for submitting this form?
Complete the four-page application and gather all necessary supporting documents. Submit translations for foreign language documents and make sure to notarize them. For assistance, contact 1-800-560-6450. Send the completed application and fee to the appropriate address provided in the instructions. Ensure all forms and documents are accurately filled out and signed before submission to avoid processing delays.
What are the important dates for this form in 2024 and 2025?
The application deadline for the National Board of Chiropractic Examiners Examination is in March and September for both 2024 and 2025.
What is the purpose of this form?
The purpose of this form is to guide applicants through the process of obtaining chiropractic licensure in the United States. It includes specific guidelines for different categories such as endorsement, acceptance of examination, restoration, and visiting professors. By adhering to these instructions, applicants can ensure their applications are processed efficiently and without delay.
Tell me about this form and its components and fields line-by-line.
- 1. Part I-A: Application Category Information - Complete the relevant category information including profession name, profession code, licensure method, and fee.
- 2. Part I-B: Check the box indicating the appropriate information regarding your application.
- 3. Part II: Applicant Identifying Information - Enter personal details including name, address, and contact information.
- 4. Part III: Education Information - Provide details of pre-chiropractic and chiropractic education.
- 5. Part IV: Record of Licensure Information - List any licenses or authorizations held as a chiropractor.
- 6. Part V: Record of Examination - Include all examination attempts and dates taken for chiropractic licensure.
- 7. Part VI: Personal History Information - Answer all six questions and provide explanations and documents for any 'yes' responses.
- 8. Part VII: Examination Coding Information - Not applicable.
- 9. Part VIII: Child Support and Student Loan Information - Complete this section if it applies.
- 10. Certifying Statement: Read, sign, and date your application.
What happens if I fail to submit this form?
Failure to submit this form or incorrect submission can lead to significant delays in processing your application. It may result in denial of licensure or temporary inability to practice.
- Processing Delay: Incorrect or incomplete form submission may delay the application process.
- Denial of Licensure: Failure to provide necessary documentation can lead to a denial of your licensure application.
- Incomplete Application: Failure to fill out all required fields and provide accurate information can result in an incomplete application.
How do I know when to use this form?
- 1. Endorsement Application: Use this form to apply for licensure based on endorsement from another state.
- 2. Examination Acceptance: Use this form if you have passed the National Board of Chiropractic Examiners Examination.
- 3. Restoration: Use this form to restore a lapsed chiropractic license.
- 4. Visiting Professor: Use this form to apply for a temporary license as a visiting professor.
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