Please note the following steps and information required in order to complete an application for a New Facility Permit.
- FACILITY INFORMATION - Name and contact information for the applying facility.
- REGULATORY COMPLIANCE - Historical information regarding this or other facility locations.
- DCs - Applicants can provide up to 4 DCs on the staff with required name and license number.
- OWNERS - Information regarding the facility's owners, including contacts, percentage of ownership and regulatory questions.
You must verify that they are a citizen or are legally present in the United States by submitting any
of the form(s) or type(s) of documentation described on the attached list.
- RECEIPT and NOTARY - The printed application must be signed by ALL owners and notarized before being mailed into the Alabama office.
- Jurisprudence Exam to be taken by the applicant if an individual(s) or if an entity the person(s) who will be most directly involved in the operation of the practice.
- Submit ALEA Release Form, 2 Fingerprint Cards, and a Money Order for $38.25 payable to ALEA Records and Identification.
Per 34-24-160(b) and 34-24-165(f):
The fingerprints will be utilized to conduct a federal and state criminal background check. Being possessed of sound mind and legally
competent to complete this request, the applicant authorizes the Alabama Board of Chiropractic Examiners to obtain any and all criminal
history information on said applicant from the ALEA and/or FBI. Applicant may challenge or appeal any portion of his/her own Criminal History
Record Information (CHRI) that he/she believes to be incomplete or inaccurate by visiting the website of the Alabama Law Enforcement Agency (ALEA)
or call (334) 353-4340. ** Your application cannot be finally processed
until the appeal is decided. Submit ALEA Release Form, 2 Fingerprint Cards, and a Money Order for $38.25 payable to ALEA Records and