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Notification of Address Change (DC)

 Description

This form is used to officially notify the Board of a change in your home or business address. All licensed chiropractors must report address changes within 60 days of the effective date.

Proof of the new address must be submitted with the form. If the change is reported late, a penalty may apply and must be paid before the update can be processed.

Estimated Time to Complete: 5 minutes, assuming all required documentation is complete and ready to submit.
 Required Documentation*

IMPORTANT: Please have all required documentation ready before purchasing. You will be asked to send these documents as part of the online process.

Documentation to be sent by the applicant or license/registration holder:
  • Completed .pdf Application (including additional required documents mentioned in .pdf)

*The documents listed are the materials generally required to meet the Board’s requirements. Additional documentation may be requested if needed to complete the review.

 Instructions
This is a complimentary (free) service. Email the completed form to: mdh.chiropractic@maryland.gov so we may begin processing.