Ariz. Admin. Code § R4-8-303 - Renewal of an Auricular Acupuncture Certificate
A. An auricular acupuncture certificate
expires 12 months after the date issued.
B. The Board shall provide a certificate
holder with 60-days notice of the need to renew. It is the responsibility of
the certificate holder to renew timely. Failure to receive notice of the need
to renew does not excuse failure to renew timely.
C. If a certificate holder fails to submit a
renewal application packet as described in subsection (D) on or before the
expiration date, the certificate holder shall cease the practice of auricular
acupuncture.
D. To renew an
auricular acupuncture certificate, a certificate holder shall submit to the
Board:
1. A renewal application that provides
the following information listed about the certificate holder:
a. Name;
b. Certificate number;
c. Renewal date;
d. The name, address, and telephone number of
the alcoholism, substance abuse, or chemical dependency facility at which the
certificate holder works;
e.
Residential and e-mail addresses;
f. Residential and mobile telephone
numbers;
g. A statement of whether
during the last 12 months a licensing authority of another state, district, or
territory of the United States or another country or subdivision of another
country denied the certificate holder a license or certificate to practice
auricular acupuncture and if so, the name of the jurisdiction denying a license
or certificate, date of the denial, and an explanation of the
circumstances;
h. A statement of
whether during the last 12 months a licensing authority of another state,
district, or territory of the United States or another country or subdivision
of another country revoked, suspended, limited, restricted, or took other
action regarding the license or certificate of the certificate holder and if
so, the name of the jurisdiction taking action, the action taken, date of the
action, and an explanation of the circumstances;
i. A statement of whether during the last 12
months the certificate holder has been convicted of a crime, including driving
under the influence of drugs or alcohol, other than a minor traffic offense,
and if so, the name of the jurisdiction in which convicted, the nature of the
crime, date of the conviction, and current status;
j. A statement of whether during the last 12
months a claim for malpractice or a lawsuit was filed against the certificate
holder alleging professional malpractice or negligence in the practice of
auricular acupuncture, and if so, the claim or case number, date of the claim
or lawsuit, the matters alleged, and whether the claim or lawsuit is still
pending or the manner in which it was resolved;
k. A statement of whether during the last 12
months the certificate holder has any condition that may impair the certificate
holder's ability to practice auricular acupuncture safely and skillfully, and
if so, the nature of the condition and any accommodations necessary;
l. A statement of whether during the last 12
months the certificate holder resigned, voluntarily or involuntarily, from a
health-care facility while under investigation, and if so, the name of the
health-care facility, the date of the resignation, and an explanation of the
circumstances;
m. A statement of
whether during the last 12 months the certificate holder had a health-care
facility terminate, restrict, or take any other action regarding the
certificate holder's employment, professional training, or privileges, and if
so, the name of the health-care facility, the date of the action, and an
explanation of the circumstances; and
n. The name, license number, and telephone
number of the licensed acupuncturist who supervises the certificate
holder;
2. A completed
Arizona Statement of Citizenship and Alien Status for State Public Benefits,
which is a form available from the Board;
3. The renewal fee required under
R4-8-106(A)(7); and
4. The
certificate holder's dated signature affirming that the information provided is
accurate, true, and complete.
E. The Board does not have authority to
reinstate an expired auricular acupuncture certificate. An individual whose
auricular acupuncture certificate expires because of failure to renew timely
under subsection (D) may apply for certification by complying with
R4-8-301.
Notes
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