Current through Register Vol. 30, No. 38, September 20, 2024
In addition to the requirements of
R4-18-201,
an applicant for licensure by examination shall meet the requirements of A.R.S.
Title 32, Chapter 14 and provide the Board:
1. A completed application form, provided by
the Board that is signed, dated, and verified; which shall include the
following information;
a. Applicant's full
name and any former names used by the applicant;
b. Place and date of birth;
c. Social Security number;
d. Home, business, and e-mail
addresses;
e. Home, business, and
cell phone numbers;
f. A completed
Arizona Statement of Citizenship and Alien Status for State Public Benefits,
and copy of evidence;
g. The name
of the approved naturopathic college applicant graduated from, date of
graduation, and date of clinical training completion;
h. The date applicant took and passed the
required NPLEX examinations of Part I; Biomedical examination, Part II;
Clinical Science examination, Part II; Core Clinical Science Examination, and
the Clinical Elective examinations in acupuncture, and minor surgery. The date
applicant took and passed the examination in Arizona naturopathic jurisprudence
that is administered by the Board. Applicant must have taken and passed all the
required examinations within a five-year period immediately preceding the date
of application submission to the Board;
i. A list of all license or certificates
issued or denied by any agency. Applicant must cause to have a document
submitted directly to the Board from each agency listed, containing the
applicant's name, date of issuance or denial, current status, and whether or
not any disciplinary actions are pending or have ever been taken;
j. Whether applicant has ever been arrested,
charged with, convicted of, or entered into a plea of no contest to a felony or
a misdemeanor;
k. Whether applicant
has ever had a naturopathic medical license or certification, or any other
health profession license or certification denied, suspended, rejected or
revoked by any agency;
l. Whether
applicant has ever been disciplined by any agency for any act of unprofessional
conduct as defined in A.R.S. §
32-1501;
m. Whether in lieu of disciplinary action,
has applicant ever entered into a consent agreement or stipulation with a
licensing agency;
n. Whether
applicant currently has an open complaint or is involved in any open
investigation in any agency or court of law, in any state or territory of the
United States;
o. Whether applicant
has ever had the authority to prescribe, dispense, or administer a natural
substance, drug, or device limited, restricted, modified, denied, surrendered
or revoked by a federal or state agency or court of law;
p. Whether applicant has ever been found
medically incompetent;
q. Whether
applicant has ever been a defendant in any malpractice matter that resulted in
a settlement or judgment;
r.
Whether applicant has a medical condition that in any way impairs or limits
applicant's ability to practice medicine, and;
s. A detailed explanation and supporting
documentation for each affirmative answer to questions regarding the
applicant's background;
2. A copy of the applicant's complete NPLEX
examination record, to be sent directly to the Board by the North American
Board of Naturopathic Examiners ("NABNE") or its successor;
3. A complete transcript sent directly to the
Board from the approved school of naturopathic medicine from which the
applicant graduated. The transcript shall include the date of graduation and
the date of completion of clinical training;
4. A complete and legible fingerprint card,
including the DPS processing fee;
5. A passport size photograph taken within 60
days prior to application submission that is signed on the back by the
applicant, and;
6. The fees
specified in
R4-18-107.
