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INITIAL APPLICATION PREPARATION

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) at www.alea.gov 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 Identification.
Your application cannot be finally processed until the appeal is decided.
Applicants will be given the opportunity to edit their information before submitting their application.
Please note that all payments with this online application are required by credit card.
To reprint or continue a previous application, click here.
Policy Questions: 800-949-5838 or sheila.bolton@chiro.alabama.gov
Technical Support: 866-353-3468 or support@alabamainteractive.org