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Applications
and Forms
All forms may be viewed and printed with the free Adobe Acrobat
Reader 6.0 or higher.
Interactive Forms Below: Click Here for the
Interactive Forms Instructions
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Initial
License Applications
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Chiropractic
License Application, #08-0672, Revised 06/13/11. Application and
instructions for licensure by examination or for licensure by
credentials.
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Courtesy
License Application, #08-4500, Revised 08/12/10. Application and
instructions for out-of-state chiropractic physicians working at
a special athletic, cultural, or performing arts event in the
State of Alaska.
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Chiropractic
Application for Locum Tenens Permit, #08-4319, Revised 08/12/10.
Application and instructions for out-of-state chiropractic
physicians substituting in an Alaska-licensed chiropractic
practice.
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Renewal
and Reinstatement Applications
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Biennial Chiropractic Physician License Renewal,
#08-0094, Revised 11/04/10
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Chiropractic
License Reinstatement Application, #08-4170, Revised 06/13/11.
Application and instructions for reinstating a license that has
been lapsed or in retired status for more than two years but
less than five years.
(Licenses lapsed or in retired status for more than five years
may not be reinstated. See application for new license.)
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Chiropractic
License Reactivation Instructions, #08-4563, Revised 06/13/11.
Instructions and information for reactivating an inactive or
retired status license.
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Miscellaneous
Forms
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Application
for Continuing Education Program Approval, #08-4003, Revised
10/14/10.
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Chiropractic
Specialty Designation Application, #08-4061, Revised 10/04/10.
Application to add a postgraduate specialty to an existing
chiropractic license.
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Request
for Peer Review, #08-4371, Revised 10/04/10.
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Application
for Appointment to Peer Review Committee, #08-4370, Revised
10/04/10.
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