Forms and Downloads

Forms are in PDF file format and require Adobe Acrobat Reader to view. You can get this free software from the Adobe WEB site. .

If you have problems downloading these forms you may contact the Board at 602-542-8154 or email us at chris.springer@azhomeopathbd.az.gov.

 

Application Information

• License Information  

• Application for License as a Homeopathic Physician

• Arizona Statement of Citizenship Form - File with new Applications

• Application Instructions for Licensing as a Homeopathic Physician

• Dispensing Permit for New Application or Renewal  

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

• Medical Assistant application Form III - Registration form for Medical Assistants who have held or currently hold another health care license, certificate, or registration

Other Forms

• Continuing Education Application  - Apply for approval of CME

• Customer Survey - Print form and FAX to Board (602-542-3093)

• List of Misdemeanor/Felony Violations Reportable by Law A.R.S. §32-3208

• Public Records Request Form - Print form and FAX to Board to request public records (602-542-3093)

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