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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Certificate to Dispense/Renewal Certificate to Dispense Certificate to Dispense means an approval granted by the Board to dispense a natuural substance, drug, or device. Defiinitions R-4-18-901 Qualifications R4-18-902 Be aware that if you do not renew your Certificate to Dispense, you will be subject to pay a renewal and late fee for each year the license has been expired. If you do not use your Certificate to Dispense, you can CANCEL your Certificate to Dispense to avoid extra fees in the future, go to nd.az.gov then Forms →Request tab.  Certificate to Dispense Application, CTD 2021 renewal app (1).pdf |
| Clinical Training Certificate No Longer Required |
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Conduct Preceptorship Certificate This application is for a Naturopathic Doctor to conduct a preceptorship program this is a initial/renewal application. Preceptorship Conduct Application New and Renewal |
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Engage in Preceptorship Certificate It is the responsiblity of the certifiacate holder to renew in a timely manner. Preceptorship Training Renewal, Precept. Engage App November 2023.pdf, Background Check Procedures and Instructions.pdf |
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Medical Assistant Application / Medical Assistant Renewal Read the application and requirements prior to applying for a Medical Assistant Certificate. Background Check Procedures and Instructions.pdf, Medical Assistant April 2024 Application.pdf, MA Renewal.pdf |
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Medical License Reinstatement Form Read the application for reinstating prior to applying ADDRESS OF RECORD2021.pdf, Reinstatement Application November 2023.pdf, Background Check Procedures and Instructions.pdf |
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Naturopathic Medical License Please review Medical License application prior to applying, you will apply based on exam , endorsement or universal recognition. ADDRESS OF RECORD2021.pdf, Medical License Application Form Nov. 2023.pdf, Background Check Procedures and Instructions.pdf |
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Specialist Certificate Specialist Certificate shall meet the requirements of A.R.S. Title 32 Chapter 14. Specialty Certificate Application.pdf |
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Address/Name Change This is a fillable form, you will need to save changes and email the form to [email protected] print and send via mail to 1740 W. Adams, Ste. 3002 Phoenix, AZ. 85007 |
Address Name Change 2017 WF.pdf |
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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 |
| Medical Consultant Request |
Medical_Consultant.pdf |
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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 |
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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 |
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.
