Chiropractic Clinical Assistant Application and Exam Registration for Certificate of Competency

I hereby apply for certification as a Certified Chiropractic Clinical Assistant per N.C.G.S. 90-143.4, and along with this completed application/registration, and delivery to the Board office of the required documentation outlined below, I agree to pay the $20 application fee required by the NC State Board of Examiners.

1. Upload a copy of your High School Diploma or High School Transcripts or GED or equivalent.
2. Upload a copy of your Driver’s License or Birth Certificate.
3. Attestation of Good Moral Character (you email form at bottom of application)