Your informal, unofficial, and confidential feedback will help us design a reference for use by chiropractic regulatory authorities as they may find helpful, particularly as more people apply from other countries.

Check all data fields you think should be included on an application for a new license or registration.

Think about applicants from other jurisdictions applying to the board in your jurisdiction. They may be recent graduates or experienced practitioners.
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In most cases, information collected on an application is for board use only and not published on the board's website unless otherwise specified.

The terms licensure and registration may be used interchangeably. 
IN YOUR OPINION, what should be included on an application for initial licensure or registration?

    BEGIN SURVEY

    SECTION 1 - IDENTITY (in addition to legal name)

    SECTION 2 - CONTACT INFO

    License status, number, expiration date would be included

    SECTION 3 - EDUCATIONAL CREDENTIALS ​

    Official certified copy of transcripts to be sent directly to Board

    Section 4 - ​EXAMINATION CREDENTIALS

    SECTION 5 - HEALTH

    SECTION 6 - ​TYPE OF LICENSE OR REGISTRATON

    Examples: General, Limited, Temporary, Telehealth, Nonpracticing or Retired, Senior Active (still in practice, 25 years, over 60 years in age), Student, Other

    SECTION 7 - ​PROFESSIONAL LICENSE VERIFICATION

    Documentation of Registration and Standing must to be forwarded directly from each registration authority to your board
     (USA - NPDB fee is $3, would be paid by applicant)

    SECTION 8 - ​POSTGRADUATE SPECIALTIES AND CERTIFICATIONS

    SECTION 9 - CRIMINAL BACKGROUND CHECk

    Documents cannot be more than six (6) months old at the time application is submitted

    SECTION 10 - ​PRACTICE HISTORY / RECENCY OF PRACTICE

    Attach to application a signed and dated curriculum vitae that describes full practice history and any clinical or skills training undertaken

    SECTION 11 - ACADEMIC FACULTY APPOINTMENTS / STAFF PRIVILEGES

    Requested info would include name of institution, address, title of appointment or privileges, dates, whether under appeal if applicable

    SECTION 12 - EXPEDITED OR ASSISTED PROCESSING

    SECTION 13 - ​INDEMNITY / LIABILITY COVERAGE / MALPRACTICE INSURANCE

    Would require name of current policy provider who also sends proof of coverage to board

    section 14 - Check all OTHER REQUIREMENTS on an applicatioN

    SECTION 15 - ​PERMISSION TO WORK IN COUNTRY

    Applicant should select either Citizen or Non-Citizen lawfully present, OR Foreign National not physicially present

    SECTION 16 - ​AVAILABILITY FOR DISASTER

    SECTIONS 17, 18, 19

    No survey questions on these three sections
    17.  PRIVACY NOTICE - Applicant attests to understanding how information will be used
    18.  APPLICANT CONTINUING RESPONSIBILITIES - Applicant attests understands and will comply with board requirements (would be listed)
    19.  AFFIDAVIT AND RELEASE OF INFORMATION - Applicant authorizes release of info, attests is complete and accurate

    SECTION 20 - ​LETTERS OF REFERENCE

    THANK YOU!

    Your insights are valued and will be thoughtfully considered.

    Applications are often the first place that someone may interact with the board in your jurisdiction. We hope to provide a helpful reference that boards may use to review their current applications, and that newly regulated jurisdictions may find to be a good starting point in creating their initial applications.

    We hope that the process of completing this survey has brought some new ideas to your own table.

    Any decisions about applications should be made in consultation with the board's legal counsel. None of the information herein is to be construed as legal advice.