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.

The application deadline for the National Board of Chiropractic Examiners Examination is in March and September for both 2024 and 2025.

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.

• 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.

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.

• 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.