Form Bol-Acu-1 - Acupuncture Application - Idaho Bureau Of Occupational Licenses
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9APPLICATION FOR ACUPUNCTURE LICENSE, CERTIFICATION & TECHNICIAN
INSTRUCTIONS
The following application consists of an instruction page and four pages which require responses. Please
complete the entire application by providing all of the requested information. Your signature must be notarized
and the appropriate fees must be attached. Submit the completed form to the address noted below. The Board
will consider only those properly completed applications that are received at least thirty (30) days prior to the
regularly scheduled meeting of the Board.
NOTE: ANY PRACTICE OR SOLICITATION OF ACUPUNCTURE IN IDAHO PRIOR TO
OBTAINING A VALID LICENSE OR CERTIFICATE IS UNLAWFUL AND MAY RESULT IN
CRIMINAL PROSECUTION AND DENIAL OF LICENSURE. (§54-4703. & §54-4713., I.C.)
Please read all questions carefully. Several questions, if answered “Yes”, require additional documentation. You
are required to contact the source of the required documentation and request the documentation be submitted
directly to the Board office at the address below. If the source will not provide the documentation, or the
documentation is otherwise unobtainable, you must submit a written explanation and any documents in your
possession that would assist the Board in reviewing your application. All requested information, application
fee, and initial license fee must be provided. Failure to provide a complete application will result in a
processing delay.
APPLICATION FEE
$100.00
AND
INITIAL LICENSURE FEE
$200.00
OR
INITIAL CERTIFICATION FEE
$200.00
OR
INITIAL TECHNICIAN FEE
$150.00
Questions regarding this application or the requirements for licensure may be addressed to:
BUREAU OF OCCUPATIONAL LICENSES
700 WEST STATE STREET, PO BOX 83720
Boise, Idaho 83720-0063
E-mail -
acu@ibol.idaho.gov
Web site –
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BOL-ACU-1 – 04/2010
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