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2008
Chiropractic License Renewal Information and Instructions
This
version of the 2008 License Renewal Application is a PDF
document that may be filled out electronically. If you
choose to complete the application electronically, please
remember to sign it once you print it out. You may also
print the application and complete it by hand. Applications
must be postmarked by January 1, 2007
We
now accept VISA and Mastercard! If paying by credit
card, you must indicate the card type, card number and
expiration date on your application. If your application
is received postmarked after January 1, 2008 your credit
card will be charged an additional $150 penalty fee. Your
signature on the application indicates your authorization
for payment.
There
is NO grace period for renewal. Many of you mail your
renewal application from a post office on December 31;
however, these envelopes are frequently postmarked January
2. Applications postmarked after January 1 will be automatically
returned to you and assessed a $150 penalty fee.
Incomplete
renewal applications will be returned to you indicating
the reason for the return. If the application is not resubmitted
postmarked by January 1, a $150 penalty fee will be assessed.
If
you need your renewal card by January 1 you must submit
your completed license renewal application to the Board
office at least 3 weeks prior to January 1. You may wish
to consider sending your application via guaranteed mail
to ensure timely delivery.
If
You Live AND Practice Out of State - You may achieve
all CE outside the state of Ohio. All CE credit earned
must follow the guidelines of Categories 1, 2 and 3.
To
Inactivate or Retire Your License
If you would like to inactivate or retire your license,
complete the application and check the "Inactive"
or "Retired" box on question 7. No fee or proof
of CE is required to inactivate or retire your license.
Return the completed application to the Board office postmarked
by January 1, 2008. A letter will be sent to you confirming
your inactive or retired status. If you are inactive or
retired you are not permitted to practice chiropractic
in the state of Ohio. If you wish to reactivate your license
at a later date, contact the Board office for reinstatement
instructions.
The
following could result in discipline and/or a fine of
up to $2,500:
- Making
a false, fraudulent, or deceitful statement on your
License Renewal Application
- Falsifying
your continuing education records
- Failing
to maintain your continuing education records for three
years
Continuing
Education Audit
If your application is selected for audit, you will receive
notice in writing. You will be given thirty days to submit
documentation of your CE. The documentation you provide
must match the CE you attested to on your renewal application.
You
are required to retain verification of the CE credit you
earn in Categories 1, 2 and 3. Category 1 and 2 CE documentation
must be issued by the sponsor. Documentation for Category
3 CE must be detailed. If you read journals or publications,
document the title, date, publisher and time spent reading.
If you attend a seminar or earn on-line continuing education,
you need some form of written verification for your records.
Question
(1)
Please read this question carefully and identify ALL
facilities that are relevant.
If
you have additional locations to report you must provide
this information on question (8) on the back of the application
or on a separate sheet of paper. You must provide the
same information that is requested for question (1).
Questions
(4) & (5)
If you answer "yes" to either of these questions
you must provide detailed information. For question
(4) you must provide a full explanation regarding the
action taken against you and by what entity.
For
question (5) you must provide a full explanation of the
circumstances, the party or parties involved, name of
the court, case number, charge(s), dates and dispositions.
If you have copies of the court records in your possession,
attach copies to the application.
Question
(6)
You must attest to completing a minimum of 24 hours of
continuing education. If the hours attested to do not
add up to 24 or you do not fill in all of the blanks,
your application will be returned. If applicable, the
$150 late fee will be assessed.
You
must earn a minimum of 12 hours from a Category 1 and/or
2 seminar. The second 12 hours may be earned in Category
1, 2 or 3. You are required to document these hours
in the spaces provided for each category. If you live
and practice in Ohio, out of state seminars may only be
documented under Category 3.
DO NOT send your certificates or proof of attendance
with your application. This information will be requested
if you are audited. Please note that you are required
to keep proof of continuing education for no less than
three full renewal cycles.
If
you have any further questions about the renewal application
or continuing education, you may contact the board office
at (614) 644-7032 or visit our website at www.chirobd.ohio.gov.
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