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Arizona Board of Homeopathic and Integrated Medicine Examiners

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All Forms and Applications

Applicant's Checklist


PDF icon Download Form (21.76 KB)

This checklist provides requirements and guidance for new license applications. Please ensure that all instructions have been completed.

Application for Homeopathic Physician


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Application for license as a homeopathic physician.

Arizona Statement of Citizenship Form


PDF icon 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. 

Continuing Education Application


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Apply for approval of CME.

Customer Survey


PDF icon Download Form (24.57 KB)

Print form and FAX to Board (602-542-3093).

Dispensing Permit


PDF icon Download Form (689.47 KB)

For new applications, or renewal.

Homeopathic Physician Renewal Form


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Application for renewal of license for a Homeopathic Physician

Fill this Renewal form out and pay for it ONLINE by clicking below

ONLINE RENEWAL FORM AND PAYMENT

Informed Consent


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A.R.S. § 32-2933(41) (relates to professional conduct).

Initial Licensing Information


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This information packet explains the requirements for licensure. 

List of Misdemeanor/Felony Violations


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Reportable by Law A.R.S. §32-3208.

Medical Assistant Application


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Registration form for Medical Assistants who have completed formal educational programs or on-the-job or practical education programs.

Medical Assistant Application Form III


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Registration form for Medical Assistants who have held or currently hold another health care license, certificate, or registration.

Medical Assistant Renewal Application


PDF icon Download Form (114.65 KB)

Public Records Request Form


PDF icon Download Form (63.36 KB)

Print form and FAX to Board to request public records (602-542-3093).

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Contact Us
Board of Homeopathic and Integrated Medicine Examiners
1740 W. Adams St
Phoenix, Arizona 85007
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Phone: (602) 542-8154
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