License Application Forms

Important Notice: DO NOT use Form 1 if you are already licensed in this profession in New York State. A New York State professional license is valid for life unless it is revoked, annulled, or suspended by the Board of Regents. To practice in New York State, your professional license must be registered. To renew your registration online, visit www.op.nysed.gov/renewalinfo.htm. If your registration has lapsed, contact us to request a Delayed Registration Application, or call 518-474-3817 Ext. 570.

Note: For fillable PDF forms, Internet Explorer is the recommended browser.

Online Form 1 - Application for Licensure
All applicants for licensure must initially submit Form 1 along with the $294 licensure and first registration fee. You must answer all questions and provide all information requested unless otherwise indicated. Failure to accurately complete all required parts of the application will delay its review. Additional forms below are required based on the licensure requirements of the profession. Do not use Form 1 to renew your existing license.

Continuing Your Application
If you have started an application within the past 30 days, and have not yet completed it, you can use this link to continue your application. You will need your Application ID, Social Security Number, and Date of Birth.

Upload Additional Documentation
If you have already completed an application, but you have additional documents or files to include in your previous submission, use this link to upload additional documentation. You will need your Application ID and Date of Birth.

Change Address or Name  - You are required to notify us within 30 days of any address or name changes. Please read the instructions to request this change.


Form 2 - Certification of Education - ( PDF 15 KB)
This form must be submitted directly by the professional school.

  • Section I: Complete this section and send the form to the professional school where you completed your chiropractic educational program.
  • Section II: The Registrar or appropriate school official must complete this section and return the form directly to the Office of the Professions at the address at the end of the form together with an official transcript.

Transcripts are required from each preprofessional college or postsecondary school attended.

Electronic Transcript Service

The Office of the Professions (OP) will accept official electronic transcripts from educational institutions (i.e. colleges/universities) or designated third-party* transcript entities located in the United States provided that:

  • The transcript is the certified true and official academic record and the document does NOT have an expiration date**.
  • OP can independently verify that the transcript is received directly from the educational institution’s registrar or officially designated third-party.
  • If a third-party transcript provider is involved, it is clear that the educational institution has designated the third party as the official sole provider of its transcripts.
  • The applicant had no opportunity to directly access or alter the transcript before it is sent or transmitted.
  • Any educational institution transcript submissions should be made electronically to DPLSEduc@nysed.gov***.

*OP will only accept third-party submissions after we have determined that the arrangement between the educational institution and the third party is consistent with our security and verification standards.

**Transcript documents with expiration dates cannot be accepted. Expirations on links to the document are acceptable.

***Do NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.

Form 3 - Verification of Chiropractic Licensure in Another Jurisdiction - ( PDF 18 KB)
This form must be submitted directly by the licensing authority.

Use this form if you are or ever have been licensed in another U.S. jurisdiction.

 
  • Section I: Complete this section and forward this form to the licensing authority of the jurisdiction in which you passed the State licensure examination. Ask the licensing authority to complete Section II and submit the completed form directly to the Office of the Professions at the address at the end of the form.
  • Section II: An official from the licensing authority must complete this section and return the form directly to the Office of the Professions at the address at the end of the form.

NOTE: A separate Form 3 must be received from every state, province or country in which you are or ever have been licensed.

Form 4 - Verification of Experience - ( PDF 15 KB)

This form must be submitted directly by at least two licensed professional colleagues.

  • Section I: Complete this section and forward this form to at least two licensed professional colleagues to complete section II.
  • Section II: Ask your professional colleagues to complete Section II and submit the completed form directly to the Office of the Professions at the address at the end of the form.

NOTE: A separate Form 4 must be received from each licensed colleague verifying your professional experience.

Last Updated: November 13, 2019