Board of Chiropractic Examiners

Application/Forms

All forms may be viewed and printed with the free Adobe Acrobat Reader 6.0 or higher.

Initial License Applications

  • Chiropractic License Application, #08-0672, Revised 06/13/11. Application and instructions for licensure by examination or for licensure by credentials.
  • 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.
  • 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.

Renewal and Reinstatement Applications

NOTE: Licenses lapsed or in retired status for more than five years may not be reinstated. See the initial license application.

  • Renewal applications for the January 1, 2015 through December 31, 2016 licensing period will be available approximately 30 days before the December 31, 2014 expiration date of your license. Prior year renewal applications are not valid for other renewal years.

    If you need a renewal form for the January 1, 2013 through December 31, 2014 renewal period, please contact the Division at (907) 465-2588 or (907) 465-2550.

  • 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.
  • Chiropractic License Reactivation Instructions, #08-4563, Revised 06/13/11. Instructions and information for reactivating an inactive or retired status license.

Miscellaneous Forms