All Forms and Applications
Applicant's Checklist Download Form (21.76 KB) |
This checklist provides requirements and guidance for new license applications. Please ensure that all instructions have been completed. |
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Application for Homeopathic Physician Download Form (248.36 KB) |
Application for license as a homeopathic physician. |
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Arizona Statement of Citizenship Form Download Form (267.5 KB) |
File with new applications. Arizona Revised Statutes § 41-1080(F) requires, in general, that a person applying for a license must submit documentation to the licensing agency that satisfactorily demonstrates that the applicant is lawfully present in the United States. |
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Continuing Education Application Download Form (406.01 KB) |
Apply for approval of CME. |
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Customer Survey Download Form (24.57 KB) |
Print form and FAX to Board (602-542-3093). |
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Dispensing Permit Download Form (689.47 KB) |
For new applications, or renewal. |
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Informed Consent Download Form (1.02 MB) |
A.R.S. § 32-2933(41) (relates to professional conduct). |
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License Information Download Form (1.25 MB) |
This information packet explains the requirements for licensure. |
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List of Misdemeanor/Felony Violations Download Form (23.59 KB) |
Reportable by Law A.R.S. §32-3208. |
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Medical Assistant Application Download Form (367.95 KB) |
Registration form for Medical Assistants who have completed formal educational programs or on-the-job or practical education programs. |
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Medical Assistant Application Form III Download Form (652.47 KB) |
Registration form for Medical Assistants who have held or currently hold another health care license, certificate, or registration. |
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Public Records Request Form Download Form (63.36 KB) |
Print form and FAX to Board to request public records (602-542-3093). |
