Applications and Forms

Acupuncture License Initial Application and Information

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.

PDF icon Fingerprint Instructions, PDF icon Initial Acupuncture License Application

Acupuncture license renewal application

Form to renew an Arizona acupuncturist license.

PDF icon Renewal Application Form

Auricular acupuncture certificate initial application

Application form to become certified in Arizona as an auricular acupuncturist.  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.

PDF icon 16--Revised initial application form.pdf

Auricular acupuncture certificate renewal application

Form to renew an Arizona auricular acupuncturist certificate.

Microsoft Office document icon 16--Revised renewal auricular application form.doc

Continuing education application

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.

PDF icon 16--CEU Application.pdf

Complaint Form

Instructions and form to initiate a complaint against an acupuncturist.

PDF icon Complaint Form

Public information request form

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

PDF icon Public Information Request Form

Name, address and phone number change form

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

PDF icon Contact Information Change Form

Statement of Citizenship Form

Use this form to declare status of citizenship when applying for a license.

Microsoft Office document icon Citizenship Form