Antelope-Canyon
Applications and Forms

Acupuncture License Initial Application and Information

Forms

You may file an application for a Temporary License along with this application for a 30 day license to practice while your application for full licensure is pending.

 

Email is always the best way to receive a speedy response.  You can email at [email protected]

We are phasing out our paper applications.

Please file all new applications using our online licensing system.  The system can be found by clicking this link:  

E-Licensing Website

Application form and additional information to become a licensed acupuncturist in Arizona. All required documents for this application must be received by the Board office 14 days prior to the next scheduled board meeting, to complete administrative review and to be scheduled for board consideration. All acupuncture license applicants must submit a set of fingerprints as part of the licensing process.

Please submit the Initial Application, Fingerprint Card, AND Citizenship Form with your other documentation.

 

Requirements for Licensure

1. Evidence of successful completion of Clean Needle Technique Course as approved by the Board.

2. Meets ONE of the following requirements and provides evidence thereof:

  • Have been certified by the National Commission for the Certification of Acupuncture and Oriental Medicine (NCCAOM), or its successor organization, OR
  • Passed all the following NCCAOM modules:
    • Point Location Module
    • Foundations of Oriental Medicine Module
    • Biomedicine Module, and
    • Acupuncture Module, OR
  • Have been certified in acupuncture by another certifying body OR examination that is recognized by the Board (State of California Acupuncture Examination), OR
  • Have been licensed by another state with substantially similar standards, AND have not had certification or licensure revoked.           

3. Graduation from or completion of training in a Board approved program of acupuncture with:

  • A minimum of 1,850 hours of training.
  • Of the 1,850 hours, at least 800 hours must be in Board approved clinical training.

4. Disclosure and evidence of all active and past professional health care licenses and certificates issued by this state, another state, district or territory of the United States.

5. A photograph taken within the past year, not less than 2” x 2”.  

6. Pay application fee and license fee in the amount of $425.00 (R4-8-106 (A)(1) and (A)(2))

7. A completed Arizona Statement of Citizenship and Alien Status for State Public Benefits form.

8. A full set of fingerprints to be submitted to the FBI and AZ Department of Public Safety and $22.00 money order made payable to the AZ Department of Public Safety

Fee Schedule

Please make checks or money orders payable to the Arizona Acupuncture Board of Examiners. Do not send cash.

Application Fee (non-refundable):

A.R.S. § 32-3927(A)(2)

$150.00

License Fee*:

A.R.S. § 32-3927(A)(1)

$275.00

Total:

$425.00

Fingerprint Processing Fee**:

$22.00

 

*The license fee is paid at the time of application.

**The fingerprint processing fee must be paid by money order to the AZ Department of Public Safety if application is submitted by regular mail.

Per. A.R.S. § 41-1080.01, if your family income does not exceed 200% of the Federal Poverty Guidelines, you may qualify for a one-time waiver of the Board’s application/licensing fee of $425.00. If you think you may qualify for this fee waiver, please file your application online and then email a copy of your family’s previous year’s federal tax return along with a request for a waiver to [email protected]

Auricular acupuncture certificate initial application

Forms

We are phasing out our paper applications.

Please file all new applications using our online licensing system. 

The system can be found by clicking this link:  E-Licensing System

All required documents for this application must be received by the Board office 14 days prior to the next scheduled board meeting, to complete administrative review and to be scheduled for board consideration.

Requirements for Certification

1. An applicant shall meet ALL the following requirements:

a. Successful completion of NADA or a Board approved training program in acupuncture for the treatment of alcoholism, substance abuse or chemical dependency that meets or exceeds standards of training established by the national acupuncture or a board approved group.

b. Successful completion of a Clean Needle Technique Course approved by the Board.

c. Completed Arizona Statement of Citizenship and Alien Status for State Public Benefits form.

d. Submit the required application.

2. Submit a photograph taken within the past year, not less than 2” x 2”. (Sign your name on the light portion of photograph, not across front.)

3. A full set of fingerprints to be submitted to the FBI and AZ Department of Public Safety and $22.00 money order made payable to the AZ Department of Public Safety

4. Payment of the application fee and certificate fee in the amount of $150.00 is due at time of application.

Other Forms

Forms

Application form for continuing education course approval.

 All required documents for this application must be received by the Board office 14 days prior to the next scheduled board meeting, to complete administrative review and to be scheduled for board consideration.

FIll out and submit the form ONLINE by clicking HERE

You must complete every field and attach supporting documentations in order to submit.

 

Public Information Request Form

to request public documents from the board such as board minutes and mailing lists.

You may file this request and pay for it online by clicking HERE(link is external)

or you may download the below form and submit by mail.

 

Name, Address, Email and Phone Number change Form

Use this form to notify the board of name, address and phone number changes as required by law.

File and submit the form online by clicking HERE

Universal Recognition Application

Forms

You may file an application for a Temporary License along with this application for a 30 day license to practice while your application for full licensure is pending

 

The universal recognition policy allows Arizona residents to use an out-of-state professional or occupational license to qualify for an Arizona license to work. To qualify, an applicant must:

-Prove residency in Arizona.

-Be currently licensed or certified for at least one year in another U.S. state in the discipline applied for and at the same level of practice as recognized in Arizona.

-Be in good standing in all states where currently or previously licensed or certified.

-Have met all applicable education, work, exam, and/or clinical supervision requirements in the other state where originally licensed or certified.

-Complete a criminal background check when required by law.

-Take and pass any applicable exam on Arizona state law.

-Pay all applicable fees to the State of Arizona Acupuncture Board of Examiners

Visiting Professor Certificate

Forms

The board may issue a visiting professor certificate to an acupuncturist who has received a teaching position in a school of acupuncture in this state if that person demonstrates to the satisfaction of the board that the person has at least five years' experience in the practice of acupuncture and has adequate skill and training. 

A certificate issued pursuant to this section allows the certificate holder to practice acupuncture only in relation to the certificate holder's faculty position duties.

A certificate is valid for one year. The board may grant a one year extension if the certificate holder submits an application at least thirty days before the certificate expires. The board may grant a total of two one-year extensions.

Requirements For Cetification

1.    Documentation of at least five years of experience in the practice of acupuncture

2.    Evidence of skill and training in the subject that the applicant will be teaching, including one of the following: 

a.    Documentation from a college or university of experience, education, or other training in the subject the applicant will be teaching; 
b.    Documentation of experience in teaching the same or similar subject matter content within the two years before the application; or 
c.    Documentation of one year of experience within the last two years in the specialized area in which the applicant is teaching; and 

3.    A detailed plan outlining the duties of the visiting professor.

4.    A photograph taken within the past year, not less than 2” x 2”.  

5.    Submit the required application to the Board.

6.    Pay certificate fee in the amount of $600.00 (R4-8-106 (A)(8) )

7.    A completed Arizona Statement of Citizenship and Alien Status for State Public Benefits form and proof of citizenship or legal alien status.