1. 1. An application form provided by the Board, signed and dated by the applicant that contains:

   1. a. The applicant’s legal name, mailing address, telephone number, and Social Security number;
   2. b. The applicant’s date and place of birth;
   3. c. The applicant’s height, weight, and eye and hair color;
   4. d. The name, address, and telephone number of the applicant’s employer, if applicable;
   5. e. The name of the licensed naturopathic physician who will supervise the applicant;
   6. f. The name and address of the institution where the applicant completed an approved medical assistant training program; or

   7. g. If the training was completed in a program provided by a licensed naturopathic physician, the following must be submitted:

      1. i. A letter outlining the training provided and signed by the naturopathic physician who provided the training;
      2. ii. Proof of passing the required medical assistant examination administered by either The American Association of Medical Assistants or The American Medical Technologists; or
      3. iii. Proof of completion of a medical services training program of The Armed Forces of the United States.
2. 2. A copy of a certificate of completion from an approved medical assistant training program or a letter of completion from an approved medical assistant training program signed by the person in charge of the approved medical assistant training program;
3. 3. A completed and legible fingerprint card; and
4. 4. The fees required by the Board under A.R.S. § 32-1527.

An applicant for a medical assistant certificate shall submit an application packet to the Board that contains the following:

Historical Note

New Section made by final rulemaking at 11 A.A.R. 1547, effective June 4, 2005 (Supp. 05-2). Amended by final rulemaking at 30 A.A.R. 346 (February 23, 2024), effective April 1, 2024 (Supp. 24-1).