Reinstatement of Acupuncture License

The following forms are needed when applying for reinstatement of your Acupuncture license:

Here are the two methods you can submit your application and supporting documents:

Our EGov Portal: Reinstatement License Application

NextRequest: GCMB Requests PortalNextRequest - Modern FOIA & Public Records Request Software

Download this pdf file. General Information and Checklist

Download this pdf file. FORM A - Affidavit of Applicant

Download this pdf file. FORM B - Authorization and Release of Records

Download this pdf file. FORM D - Exposure Guidelines

Download this pdf file. FORM E - NCCAOM Certification

Download this pdf file. FORM F - State Verification