Initial Application Information for Licensure as an Auricular Detoxification Technician

The following forms should be utilized when making application for initial licensure as an Auricular Detoxification Specialist:

General Information & Checklist

Initial Application Form

FORM A - Affidavit of Applicant

FORM B - Certification of Education

FORM C - State Verification Form

FORM D - Exposure Control/Infectious Disease Prevention

FORM E - ADT Certification of Training

FORM F - ADT Program and Supervisor Information

FORM G - ADT Employer Liability Insurance Information