Becoming a Certified Chiropractic Assistant Level I – Clinical

 Interested in applying to become a Certified Chiropractic Assistant?

Application for CCA Level I – Clinical

What you need:

  • You must be 18 years of age.
  • You must be a high school graduate (or the equivalent).
  • You must be of good moral character.
  • You must have completed at least 24 hours of board approved education with at least 6 of those hours delivered in an in-person class. Up to 18 hours of the 24 required may be online.

NOTE: The Board of Examiners does not offer educational courses.  Check with i.e. your state association or a chiropractic college for approved courses.

  • You must complete the application for certification and pay the applicable fee to this board.
  • You must pass the certification exam administered by the NC Board of Chiropractic Examiners.


Once the above requirements have been met, you will be a Certified Chiropractic Assistant Level I – Clinical.

What can you do as a CCA Level I – Clinical?

Certification means you are a non-licensed (but certified) employee of a chiropractic physician whose duties may include (i) collecting general health data, such as the taking of an oral history or vital sign measurements, (ii) applying therapeutic procedures, such as thermal, sound, light and electrical modalities, and hydrotherapy, and (iii) monitoring prescribed rehabilitative activities.

What can you NOT do as a CCA Level I – Clinical?

The law does not allow a chiropractic clinical assistant to provide a chiropractic adjustment, manual therapy, nutritional instruction, counseling, or any other therapeutic service that requires individual licensure.

Can I take Xrays?

No!  In order to take xrays in a chiropractic office, you must complete all the above PLUS you must become a CCA Level II – Xray

How do I become a CCA Level II – Xray?

  • You must complete all the requirements and hold a CCA level I certificate.
  • You must obtain 50 hours of additional training specifically in xray from a board approved provider.
  • You must complete the CCA Level II application.
  • You must pass the examination administered by the NC Board of Chiropractic Examiners.
  • Complete the practical requirement under the supervision of a Doctor of Chiropractic.


NC GS 90-143.4, 90-143.2, 21 NCAC 10. 0213 (All available from