Board of Chiropractic Examiners Notice Regarding Criminal Background Checks An applicant applying for a chiropractic license by examination or credentials is required by 12 AAC 16.030(7) or 12 AAC 16.033(10), respectively to submit an official criminal background check from all states in which an applicant has ever been licensed and from the primary residence state. Please note the following: Criminal background checks can come directly from the issuing agency to our office. Criminal background checks can come from the applicant if the report remains in its original, sealed envelope. The preferred method of receiving background checks is via hardcopy mail. Criminal background checks will be accepted via e-mail only if it can be verified that the sender e-mail belongs to a government e-mail address or similar authority. Some states do not allow distribution of criminal background checks to third parties or will not provide a report to the applicant if the intent is to forward it to a third party. If you have been licensed in a state that does not authorize the release of a criminal record report to a third party, please submit supporting documentation. Click here for an example. Initial License Applications Chiropractic License Application, #08-0672, Revised 10/1/16. Application and instructions for licensure by examination or for licensure by credentials. Courtesy License Application, #08-4500, Revised 9/23/16. 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 9/23/16. Application and instructions for out-of-state chiropractic physicians substituting in an Alaska-licensed chiropractic practice. Renewal and Reinstatement Applications Biennial Chiropractic Physician License Renewal Application, #08-0094, Revised 10/1/16. Chiropractic License Reinstatement Application, #08-4170, Revised 9/23/16. 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 9/23/16. Instructions and information for reactivating an inactive or retired status license. Please do not submit your certificates with your renewal application. Only submit documentation of your continuing education activity if you are notified that you have randomly been selected for an audit. NOTE: Licenses lapsed or in retired status for more than five years may not be reinstated. See the initial license application. Miscellaneous Forms Continuing Education Course Approval Application for Chiropractors Use this form only if you are licensed in Alaska Continuing Education Activity Log Continuing Education Course Approval Application for Providers Chiropractic Specialty Designation Application Application to add a postgraduate specialty to an existing chiropractic license. Request for Peer Review #08-4371, Revised 9/26/16. Request for Examination Review Application for Appointment to Utilization Review Committee Name and/or Address Change, or Duplicate License Request for License Verification Credit Card Authorization Form