Acupuncture Checklist of Supplemental Documentation

The following list is being provided to aid you in the completion of your application. The list is general and should in no way be considered a complete list for any one individual applicant. It is advisable that you collect all documentation and submit it in one packet, however we understand that there are some examination entities and state licensing boards that will not send the documents to you but will send them directly to us.

Applicants (excluding Relicensure and Reissuance) must submit the following:

  1. Copy of birth certificate or passport.
  2. Copy of Acupuncture Diploma.
  3. Deans Certification (Form D-AC) and certified acupuncture school transcript request that each acupuncture school you attended submit both of these forms to you in an unopened envelope(s) with a signature of an acupuncture school official across the outside envelope flap.
  4. Pre-acupuncture Education request each undergraduate school you attended submit a transcript to you in an unopened envelope with a signature of a school official across the outside envelope flap.
  5. Form L-PA/AC Verification of Acupuncture Licensure Evaluation. You must have every professional affiliation for the past 10 years fill out Form L-PA/AC. (This applies only to work performed in the United States.) For new graduates, the Program Director should complete the form and return it to you in a sealed envelope with their signature across the outside envelope flap. Do not open this envelope. Send the unopened envelope to the Texas Medical Board.
  6. Examination transcripts Contact NCCAOM and CCAOM and request that a certified transcript of all examination attempts be sent directly to the Texas Medical Board.
  7. State Board Licensure Verifications - contact each state, province or federal locale in which you have ever held a license or applied for a license as a health care professional and request that they furnish you a verification in a sealed envelope with the state board seal across the outside of the envelope. Some states may require that the verification be sent directly to the Texas Medical Board.
  8. Alternate Name - If you have recorded an alternate name on your application you are required to submit copies of documents that will support the name change. Those documents could be a marriage certificate, divorce decree, court ordered name change, or some other official document.
  9. DD 214, if applicable.

International Medical School graduates

Eligibility to practice in country of graduation Submit a copy of your license to practice in the country where your acupuncture school is located. If you do not have a license, have the licensing authority in the country where your acupuncture school is located submit a letter to you regarding your eligibility to practice as an acupuncturist, in a sealed envelope, with the licensing authorities seal stamped across the outside flap.

Relicensure Applicants

If your license has been canceled for non-payment or by request, you are required to meet current statutory requirements and board rules. Submit documentation of anything that is new or has changed since you were originally licensed, as well as documentation that is non-static, such as state board verifications.

Reissuance Applicants

If your license has been revoked by the board, you are required to meet current statutory requirements and board rules. In addition, you must furnish documentation that the reissuance of your licenses is in your best interest and in the best interest of the public. Submit documentation of anything that is new or has changed since you were originally licensed, as well as documentation that is non-static, such as state board verifications.