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INFORMATION/APPLICATION FOR CARE The following information is needed in order to better serve you. Please complete all questions. If you need help please ask the Chiropractic Assistant. PLEASE PRINT
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Form chiropractic assistant is a specific document used in the chiropractic profession to provide details about the services rendered by chiropractic assistants and their qualifications.
Chiropractic offices or practitioners employing chiropractic assistants are required to file this form to report the assistant's information and compliance with regulations.
To fill out the form, provide the chiropractic assistant's personal details, employment information, and any required certifications or education credentials. Follow the instructions provided on the form carefully.
The purpose of the form is to ensure that chiropractic assistants meet necessary qualifications and to maintain regulatory standards within the chiropractic practice.
The form must report the assistant's full name, address, certification status, employment start date, and any relevant training or qualifications.
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