OAR 847-070-0022: Documents to be Submitted for Licensure

The documents submitted must be legible and no larger than 8 ½" x 11". All documents and photographs will be retained by the Board as a permanent part of the application file. If original documents are larger than 8 ½" x 11", the copies must be reduced to the correct size with all wording and signatures clearly shown. Official translations are required for documents issued in a foreign language. The following documents are required: (1) Application: Completed formal application provided by the Board. Required dates must include month, day and year. (2) Birth Certificate: A copy of birth certificate and a copy of Change of Name documentation, Marriage Certificate, or Divorce Decree if the applicant’s name has been changed by court order, adoption, marriage, divorce, etc. (3) Acupuncture School Diploma: A copy of a diploma showing graduation from an approved school of acupuncture for those applicants who qualify under OAR 847-070-0016(1). (4) Photograph: A close-up, passport-quality photograph, front view, head and shoulders (not profile), with features distinct, taken within 90 days preceding the filing of the application. (5) A letter from the Dean of the applicant’s program of acupuncture for those applicants who qualify under OAR 847-070-0016(1). (6) A letter from the National Certification Board for Acupuncture and Herbal Medicine (NCBAHM) verifying current certification in acupuncture by the NCBAHM for those applicants who qualify under OAR 847-070-0016(1) or (2). (7) If requested by the Board, a letter verifying licensure in good standing from the state or states of all prior and current health-related licensure. (8)(a) A letter from the Director or other official for practice and employment to include a statement regarding eligibility for rehire and specific beginning and ending dates of practice and employment, for the past five (5) years only. (b) If the applicant has ceased practice for more than two (2) years, employment verifications will be required for the past ten (10) years or redacted patient logs from the past five (5) years. (c) If such verification is unavailable or incomplete, and for acupuncturists who have been or are in solo practice, three reference letters from acupuncturists in the local treatment community who are familiar with the applicant’s practice and who have known the applicant for more than six months.