PURPOSE: This rule states where to secure an application and how to complete the application and documentation required to accompany the application form provided by the executive director. 20 CSR 2070-2

1. (1) Application for licensure shall be made on the application form provided by the board.
2. (2) Application forms may be obtained by writing the board at 3605 Missouri Boulevard, PO Box 672, Jefferson City, MO 65102-0672, contacting the board office at
3. (573) 751-2104, or sending an email request for an application packet to chiropractic@pr.mo.gov.

4. (3) How to Complete the Application.

   1. (A) All information requested on the application shall be either typewritten or handwritten legibly in black ink.
   2. (B) All blanks shall be completed.
   3. (C) Applicants should not use initials or nicknames on the application. If the applicant has no middle name, this should be indicated by placing NMN in the place where information is requested. If the applicant has an initial for the first or middle name, this should be indicated by adding the word ONLY following the initial.

5. (4) Items to accompany application for licensure by examination are—

   1. (A) One (1) photograph as described in 20 CSR 2070-2.050(3)(B);
   2. (B) Application processing or examination fee in the form of a money order or cashier’s check. Applicants shall pay the application processing fee if applying for licensure by examination (N.B.C.E. Part IV examination). The examination fee must accompany an examination application only in the event that the board administers its own practical examination. See 20 CSR 2070-2.050(3)(A); and
   3. (C) Two (2) sets of fingerprints and the fingerprinting fee.

6. (5) Items to accompany application for licensure by reciprocity are:

   1. (A) One (1) photograph as described in 20 CSR 2070-2.070(4);
   2. (B) Reciprocity licensure fee in the form of a money order or cashier’s check;
   3. (C) Proof of practice as described in 20 CSR 2070-2.070(5);
   4. (D) Completed open-book jurisprudence examination;
   5. (E) Copy of high school diploma or General Educational Development (GED) Certificate if applicant was licensed prior to preprofessional requirement;
   6. (F) Two (2) sets of fingerprints and the fingerprinting fee; and
   7. (G) An applicant requesting board authorization to take the Special Purposes Examination for Chiropractic (SPEC) administered by the National Board of Chiropractic Examiners shall have an application filed with the board and pay the applicable fee as defined in 20 CSR 2070-2.090(1)(C). FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION
7. (6) An application for temporary licensure may be obtained by writing to the State Board of Chiropractic Examiners, PO Box 672, 3605 Missouri Boulevard, Jefferson City, MO 65102-0672, contacting the board office at (573) 751-2104, or sending an email request for an application for temporary licensure to chiropractic@pr.mo.gov.

8. (7) The applicant for temporary licensure shall submit the following along with the required form and fee as defined in 20 CSR 2070-2.090(1)(T):

   1. (A) An original, unretouched, black and white or color photograph of the applicant taken within the last six (6) months, showing the head and shoulders front view, not to exceed two inches by two inches (2" × 2");
   2. (B) A composite score of seventy-five percent (75%) on the jurisprudence examination regarding Missouri statutes and regulations;
   3. (C) Two (2) sets of fingerprints and fingerprint fee as defined in 20 CSR 2070- 2.090(1)(O); and
   4. (D) Satisfactory evidence that the applicant is licensed in another state to practice chiropractic.
9. (8) An applicant may request a temporary license be renewed for an additional ninety
10. (90) days upon application to the board and payment of the required fee as defined in 20 CSR 2070-2.090(1)(U).

AUTHORITY: sections 43.543 and 331.030, RSMo Supp. 2006 and 331.100.2, RSMo 2000.* This rule originally filed as 4 CSR 70- 2.040. This version of rule filed Dec. 17, 1975, effective Dec. 27, 1975. Rescinded and readopted: Filed July 9, 1982, effective Nov. 11, 1982. Amended: Filed Sept. 12, 1983, effective Jan. 13, 1984. Amended: Filed Aug. 14, 1986, effective Nov. 13, 1986. Rescinded and readopted: Filed April 18, 1989, effective July 13, 1989. Rescinded and readopted: Filed Aug. 14, 1990, effective Dec. 31, 1990. Amended: Filed Sept. 13, 1995, effective March 30, 1996. Amended: Filed March 30, 1998, effective Sept. 30, 1998. Amended: Filed Aug. 12, 1999, effective Feb. 29, 2000. Amended: Filed July 31, 2003, effective Jan. 30, 2004. Amended: Filed April 1, 2005, effective Oct. 30, 2005. Moved to 20 CSR 2070-2.040, effective Aug. 28, 2006. Amended: Filed June 27, 2007, effective Jan. 30, 2008.

*Original authority: 43.543, RSMo 1993, amended 2003, 2005; 331.030, RSMo 1939, amended 1945, 1947, 1949, 1969, 1981, 1988, 1993, 1995, 1997, 2004; and 331.100.2, RSMo 1939, amended 1949, 1969, 1980, 1981.