License Application Forms for Acupuncture

All applicants for licensure must initially submit Form 1 along with the $788 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.

This form must be completed and submitted by the educational institution. The Office of the Professions will not accept it if submitted by the applicant.

 

• Section I: Complete this section of the form before sending it to the school (s) where you completed your preprofessional education.
• Section II: The school Registrar must complete this section and return the form directly to the Office of the Professions at the mailing address at the end of the form.

The school must attach an official transcript or a notation of all courses you completed. The transcript must bear the original signature of the Registrar and original seal of the school. If you attended more than one school to fulfill the preprofessional education requirement, copy this form and send a copy to each institution.

This form must be completed and submitted by the educational institution. The Office of the Professions will not accept it if submitted by the applicant.

• Section I: Complete this section of the form before sending it to the school(s) where you completed your professional acupuncture education.
• Section II: The school Registrar must complete this section and return the form directly to the Office of the Professions at the mailing address at the end of the form.

The school must attach an official transcript or a notation of all courses you completed. The transcript must bear the original signature of the Registrar and original seal of the school. If you attended more than one school to fulfill the professional education requirement, copy this form and send a copy to each institution.

Electronic Education Documentation

The Office of the Professions (OP) will accept official electronic transcripts and forms 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 documentation 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 education documentation 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.

Complete this form if you hold, or ever held, a license or certificate to practice any profession* in any jurisdiction.

This form must be submitted directly by the licensing/certifying authority. The Office of the Professions will not accept this form if submitted by the applicant.

• Section I: Complete this section before sending the entire form to the appropriate licensing/certifying authority. Be sure to sign and date item 9. A separate Form 3 must be submitted for all licenses/certificates you have ever held except those issued by the New York State Education Department.
• Section II: The licensing/certifying authority must complete this section, sign, date and return both pages of the form directly to the Office of the Professions at the address at the end of the form.

NOTE: A Form 3 is not required for licenses/certificates issued by the New York State Education Department. Also, If the certification/verification documentation provided by a U.S. jurisdictions contains the same information requested in the Form 3, completion of a Form 3 for that jurisdiction is not necessary. For certification/verification documentation that does not contain the same information, a Form 3 will need to be completed for that jurisdiction.

*Profession is defined as professional titles licensed under New York State Education Law. 

All applicants for a limited permit must initially submit Form 5 along with the $70 limited permit fee. You must also submit a Form 5CS - Certification of Supervisor for Limited Permit along with your application.

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 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.

Changes to Supervisors and/or Settings
If you change supervisors and/or settings, or you have to add or remove a supervisor or setting, after a permit is issued, you must obtain an amended permit using the Limited Permit Change Form. After changes are processed you will receive an amended permit. A fee is not required for an amended permit issued as a result of a change in supervisor or setting. You must also submit a Form 5CS - Certification of Supervisor for Limited Permit for each new supervisor you are adding (see Upload Additional Documentation above).

This form is not for all applicants. Use this form ONLY if you are applying/have applied for a New York State Limited Permit as an Acupuncturist online.
 

• Section I: Complete this section.
• Section II: Your supervisor must complete this section before you can submit it to the Office of the Professions at the appropriate address at the end of the form. It is your responsibility to ensure your supervisor fully completes Section II. Failure to complete this form will delay its review.