Chiropractor - Temporary Permit

To apply for a temporary permit, you must hold a chiropractic license in good standing in another jurisdiction and have no disciplinary action pending in connection with any chiropractic license that you hold.

 A chiropractor holding a temporary permit to practice chiropractic may not use the temporary permit to provide relief services or practice coverage for the practice of any chiropractor licensed in this state.

To apply for a temporary permit, form 2068 Application for Chiropractic Temporary Licensure, evidence of current proficiency in the use of an automated external defibrillator, and payment form 3071 for the $10 fee must be emailed to dspscredchiropractic@wisconsin.gov. As part of form 2068 you must inform the board, in writing, of the locations at which and the dates on which you request to practice.

Supporting Documents you will be asked for:

• 2068 Application for Chiropractic Temporary Licensure Content

• Evidence of current proficiency in the use of an automated external defibrillator.

• 3071 Payment Form

Required if Applicable:

• Copy of marriage certificate or other state issued change document (only applicable if other required documents are under a different name)

To apply for a temporary permit, form 2068 Application for Chiropractic Temporary Licensure, evidence of current proficiency in the use of an automated external defibrillator, and payment form 3071 for the $10 fee must be emailed to dspscredchiropractic@wisconsin.gov.

As part of form 2068 you must inform the board, in writing, of the locations at which and the dates on which you request to practice.

• 2068 Application for Chiropractic Temporary Licensure Content
• Evidence of current proficiency in the use of an automated external defibrillator.
• 3071 Payment Form

Copy of marriage certificate or other state issued name change document (only applicable if other required documents are under a different name).

Support Ticket
Submit a support ticket on LicensE and click "request support." Please provide as much detail as possible regarding your concern so we can work to answer your question with a one touch resolution. 

Call
608-266-2112

Email
dsps@wisconsin.gov

Office Hours
7:45am-4:30pm
Department of Safety and Professional Services
4822 Madison Yards Way
Madison, WI, 53705

Note: The in-person office does not process same day.