ALL APPLICANTS SHALL REVIEW INFORMATION REGARDING FINGERPRINTING SEE FINGERPRINT SUBMISSION TAB BELOW PRIOR TO APPLICATION SUBMISSION TO THE BOARD.
- Licensing and Certification Forms
- Request Forms
- A and B List
- Fingerprint Card Submission
- Complaints
- Interstate Telehealth Registration
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Address/Name Change This is a fillable form, you will need to save changes and email the form to info@nd.az.govor print and send via mail to 1740 W. Adams, Ste. 3002 Phoenix, AZ. 85007 |
 Address Name Change 2017 WF.pdf (link is external) |
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License Verification Request This is a form to request a written verification of your Arizona Naturopathic Medical license to be sent to another state or agency. The verification will include, issue date, expiration date,also disciplianary actions if any. A $5.00 fee is to accompany the request made payableto AZND Board. |
Verification Request.pdf (link is external) |
| Medical Consultant Request |
Medical_Consultant.pdf (link is external) |
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Public Records Request Form This is a fillable form, your will fill out the form, the you will print and sign. You can mail the form with the fee, if there is no fee you can email or fax. |
Public Record Request 2024.pdf (link is external) |
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Retire/Cancellation Request Form Use the form if you would to retire your Naturopathic License or Cancel a Certificate.You can email, or U.S. mail this document. |
Retire/Cancellation Request Form (link is external) |
See Background Check Procedures and Instructions Document under the Forms tab located next to the application forms.
Applications that require Fingerprint Card Submission:
Engage in Preceptorship Certificate
Medical Assistant
Reinstatement Application
Intial Medical License Application
Also Review FBI Privacy Act Statement
To file a complaint against a Naturopathic Physician, download and complete the form. You may email to form directly to us, or mail the form.
The complaint form is located on the home page.
