New Hampshire Code of Administrative Rules
Acp - Board of Acupuncture Licensing
Chapter Acp 700 - ACUPUNCTURE DETOXIFICATION SPECIALISTS
Part Acp 702 - APPLICATION PROCEDURE
Section Acp 702.01 - Acupuncture Detoxification Specialist Application
Universal Citation: NH Admin Rules Acp 702.01
Current through Register No. 40, October 3, 2024
(a) Each applicant for certification as an acupuncture detoxification specialist shall complete and submit to the board an "Acupuncture Detoxification Specialist Certification Application", effective July 2018 and available on the board's website, which includes the following on or attached to the form:
(1) The applicant's legal name, other names
the applicant has been known by and reason for name change, mailing address,
and telephone number(s);
(2) The
date(s) the applicant attended and completed NADA or other board-approved
training;
(3) The date of
application;
(4) The applicant's
signature;
(5) The primary practice
location address that the acupuncture detoxification services will be
performed;
(6) Any additional
practice location addresses;
(7)
The applicant's date of birth;
(8)
The applicant's social security number, as required by
RSA 161-B:11,
VI-a;
(9) The applicant's email address;
(10) A copy of the NADA ethics pledge, or
ethics pledge issued by other board-approved training programs, statement
signed by the applicant;
(11) A
copy of the NADA or other board-approved training certificate of training
completion;
(12) Application fee of
$110.00;
(13) The following
information about the supervising acupuncturist:
a.Name, mailing address, and telephone
number(s);
b.License number and
expiration date; and
c.The
supervising acupuncturist's signature attesting that he or she agrees to abide
by Acp 703.01;
(14)
Attestation from the supervising acupuncturist of their own familiarity with:
a.The NADA Acupuncture Detoxification
Specialist Training Manual, effective July 1, 2017, available as noted in
Appendix II;
b.Prior NADA training
that meets or exceeds the NADA training; or
c.Other board-approved training;
(15) An indication as to whether
the applicant has had an acupuncture detoxification certificate, license, or
other similar registration revoked, suspended, or limited in this or any other
state or jurisdiction;
(16) An
indication as to whether the applicant has had a professional license or
certification in a field other than acupuncture detoxification revoked,
suspended, or otherwise terminated on disciplinary grounds;
(17) An indication as to whether the
applicant holds a current health care, recovery coach or peer counselor
professional license, certificate or other similar credential. The applicant
shall provide the professional license, certificate or credential type, number,
and state of issuance;
(18) An
indication as to whether the applicant has prior work or volunteer experience
in substance abuse or addictions treatment or behavioral health treatment;
and
(19) An indication as to
whether the applicant has successfully completed clean needle technique
training as outlined in the NADA Acupuncture Detoxification Specialist Training
Manual, effective July 1, 2017, available as noted in Appendix II, or as
outlined in the training approved pursuant to Acp 705.
(b) The applicant shall provide a detailed explanation to any affirmative answer given in response to questions (15)-(19) in (a) above.
Disclaimer: These regulations may not be the most recent version. New Hampshire may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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