Arizona Administrative Code › Title 4 - PROFESSIONS AND OCCUPATIONS › Chapter 18 - NATUROPATHIC PHYSICIANS MEDICAL BOARD › Article 5 - NATUROPATHIC CLINICAL TRAINING AND PRECEPTORSHIP TRAINING PROGRAM REQUIREMENTS › Section R4-18-501 - Certificate to Engage in Clinical or Preceptorship Training

Current through Register Vol. 30, No. 28, July 12, 2024
A. To obtain a
				certificate to engage in clinical or preceptorship training, an applicant shall
				submit to the Board a complete application form provided by the Board, that
				allows the Board to determine if the applicant meets the requirements of A.R.S.
				§
									32-1524.
				The application shall be verified, and include the fee listed in
				R4-18-107;
B. In addition to the requirements in
				subsection (A.) a naturopathic medical student who applies for a certificate to
				engage in clinical training shall comply with the requirements of A.R.S. §
									32-1560,
				and, be attending an approved naturopathic medical school. Applicant must
				arrange to have submitted directly to the Board, a letter from the chief
				medical officer of the medical school verifying that the applicant will be
				entering clinical training, and the anticipated starting and completion dates.
				The Board may deny an application for any reason set forth in A.R.S. §
									32-1501(31)
				 and A.R.S. §
									32-1522(A)(3)
				 - (6);
C. Applicant must take and pass the
				examination in Arizona naturopathic jurisprudence that is administered by the
				Board, with a minimum score of 75%, include with the application a passport
				size photograph taken within 60 days prior to application submission that is
				signed on the back by the applicant, provide a legible fingerprint card,
				including the DPS processing fee as specified on the application
				form;
D. The application form for
				clinical training entry shall include:
1.
				Applicant's full name and any former names used by applicant;
2. Applicant's place and date of
				birth;
3. Applicant's Social
				Security number;
4. Applicant's
				home and email address;
5.
				Applicant's home and cell phone numbers;
6. The name and address of the approved
				naturopathic college applicant is attending; name and address of clinical
				training program, the date of clinical entry and the date of completion of
				clinical entry;
7. The name of the
				Supervising Physician and the name of the Chief Medical Officer of the Clinical
				Training program;
8. Whether
				applicant has ever been arrested, charged with, convicted of, or entered into a
				plea of no contest to a felony or a misdemeanor;
9. Whether applicant has ever had a
				naturopathic medical license or certification, or any other health profession
				license or certification denied, suspended, rejected or revoked by any agency
				in any state, district or territory of the United States or another
				country;
10. Whether applicant has
				ever been disciplined by any agency in any state, district or territory of the
				United States or another country, for any act of unprofessional conduct as
				defined in A.R.S. §
										32-1501;
11. Whether applicant, in lieu of
				disciplinary action, has entered into a consent agreement or stipulation with a
				licensing agency in any state, district or territory of the United States or
				another country;
12. Whether
				applicant currently has an open complaint or is involved in any open
				investigation in any agency or court of law, in any state, district or
				territory of the United States or another country;
13. Whether applicant has ever had the
				authority to prescribe, dispense, or administer a natural substance, drug, or
				device limited, restricted, modified, denied, surrendered or revoked by a
				federal or state agency or court of law, in any state, district or territory of
				the United States or another country;
14. Whether applicant has ever been found
				medically incompetent;
15. Whether
				applicant has ever been a defendant in any malpractice matter that resulted in
				a settlement or judgment;
16.
				Whether applicant has a medical condition, that in any way, impairs or limits
				applicant's ability to practice medicine;
17. A detailed explanation and supporting
				documentation for each affirmative answer to questions regarding the
				applicant's background, and;
18. A
				completed Arizona Statement of Citizenship and Alien Status for State Public
				Benefits, and copy of evidence;