Chiropractic Assistant Requirements by State

Compiled by the ChiroTrack team from state board pages, statutes and administrative rules. Every source on this page was checked October 4, 2026. Found something out of date? Tell us on the corrections page.

There is no national chiropractic assistant license. Each state decides whether to register, certify or license the people who work under a chiropractor, and many do neither. This page records what each state’s own board, statute or administrative code publishes, with the source and the date we read it. It does not interpret the law for you, and it is not legal advice. Before you rely on any of it, read the source and ask the board.

How to read this page

Published The board, statute or rule says this, and the source is linked beside it.

Not published We read the pages listed on the date shown, and they publish no such requirement. That is a statement about those pages, not a promise that no rule exists anywhere.

Unverified We have not checked this, or could not open or cite the source, so we state nothing about it.

Not yet checked We have not looked at this state yet.

The gaps here are ours. “Unverified” and “not yet checked” describe the limits of our checking, not the state’s law. A board can publish a rule on a page we did not read, and rules change after we read them. If you find something we missed or something that has changed, send it to the corrections page and we will recheck it against the source.

The 22 states checked so far

We started with seven states, added Florida and Alaska as clear examples of a state certifying the role and a state requiring a national certificate, then added the thirteen states named most often in Google searches that showed this site. The order below is the order we checked them, not a ranking.

State	What the board publishes for assistants	Sources
Texas	No assistant credential	Board page, rules or statute
Tennessee	Certifies: chiropractic therapy assistant	Board page, rules or statute
Pennsylvania	No assistant credential	Board page, rules or statute
Indiana	No assistant credential	Board page, rules or statute
Georgia	No assistant credential	Board page, rules or statute
Illinois	No assistant credential	Board page, rules or statute
California	No assistant credential (change under discussion)	Board page, rules or statute
Florida	Certifies: chiropractic physician’s assistant	Board page, rules or statute
Alaska	Requires national certification: chiropractic clinical assistant	Board page, rules or statute
North Carolina	Certifies: chiropractic assistant, Level 1 (clinical) and Level 2 (x-ray)	Board page, rules or statute
Oregon	Certifies: chiropractic assistant	Board page, rules or statute
Arizona	Defines the role in statute; rule detail blocked	Board page, rules or statute
Louisiana	Certifies x-ray only: certificate of proficiency	Board page, rules or statute
Washington	No assistant credential; registers chiropractic x-ray technicians	Board page, rules or statute
Colorado	No assistant credential	Board page, rules or statute
Minnesota	No assistant credential; x-ray exam required	Board page, rules or statute
Michigan	No assistant credential; x-ray training required	Board page, rules or statute
Ohio	No assistant credential	Board page, rules or statute
Arkansas	No assistant credential	Board page, rules or statute
Connecticut	No assistant requirement published	Board page, rules or statute
Missouri	No assistant requirement published	Board page, rules or statute
Alabama	No assistant requirement published	Board page, rules or statute

Every row is detailed below with its links. All sources checked October 4, 2026.

State by state

Texas

Texas Board of Chiropractic Examiners · tbce.texas.gov

Does the board register, certify or license assistants?: Not published No registration, certification or license for assistants is published on the board pages checked. Unlicensed staff work under a delegation rule: the board defines a “qualified individual” as “an unlicensed individual with adequate education, training, and skill to perform an act.”Source: 22 TAC §78.3(a); board home page; statutes and rules page; licensure FAQ; publications and forms. Checked October 4, 2026.
What the board says may be delegated: Published The rule lists acts a chiropractor may delegate, including taking a medical history, taking vital signs, range of motion measurements, physical treatments or modalities, demonstrating exercises and supports, and radiological procedures. A chiropractor may not delegate diagnosis, a treatment plan, or adjustments and manipulations. The chiropractor must document that the person is qualified and be physically present or on call within 15 minutes. The board’s FAQ adds acupuncture and vestibular-ocular-nystagmus testing to what can never be delegated to a non-licensee.Source: 22 TAC §78.3(b)–(h); board scope-of-practice FAQ; Tex. Occ. Code §201.451. Checked October 4, 2026.
X-ray: Published A chiropractor may delegate a radiologic procedure “to an individual who has documented training and experience,” and must be on the premises while it is done. The board’s FAQ says the person “is not required to be licensed as a radiologic technologist.”Source: 22 TAC §78.5; board scope-of-practice FAQ. Checked October 4, 2026.
X-ray: the state radiologic technology law: Published Two published texts, side by side. The state’s Medical Radiologic Technologist Certification Act requires training guidelines for a person “who does not hold a certificate issued under this chapter and who is performing a radiologic procedure at a hospital or under the direction of a practitioner, other than a dentist,” and the same chapter defines “practitioner” to include a doctor of chiropractic. The chiropractic board’s FAQ says a person to whom a chiropractor delegates a radiologic procedure “is not required to be licensed as a radiologic technologist.” We draw no conclusion about how the two fit together; ask the board.Source: Tex. Occ. Code §§601.002 and 601.201(a); board scope-of-practice FAQ. Checked October 4, 2026.

Tennessee

Tennessee Board of Chiropractic Examiners · tn.gov board page

Does the board register, certify or license assistants?: Published Yes. The board certifies the “certified chiropractic therapy assistant,” and the rules say that “prior to engaging in practice as a chiropractic therapy assistant in Tennessee, a person must hold a current Tennessee certification.” Services under the title include physical agent modalities, physical treatment and clinical services, on a physician’s orders.Source: Rule 0260-05-.02 and .03 (revised July 2023). Checked October 4, 2026.
What it requires: Published At least 18 years old; a high school diploma, equivalent, or college graduation; at least 50 hours of instruction approved by the board (courses run by the Tennessee Chiropractic Association need no prior approval); passing the board examination; and 1,200 hours of clinical internship under direct supervision, completed within a year of the exam. Board fees in the rule: $150 application, $100 renewal, $10 state regulatory fee. Six clock hours of continuing education a year, and the rule gives no credit for multi-media courses.Source: Rules 0260-05-.04, .06, .08 and .12. Checked October 4, 2026.
Staff without the certificate: Published A chiropractor may not let staff perform services “for which the personnel do not hold the license or certification required,” including services that require the therapy assistant or x-ray technologist certificate.Source: Rule 0260-02-.13(10). Checked October 4, 2026.
X-ray: Published A separate board certificate: “certified chiropractic x-ray technologist.” It requires 50 hours of approved instruction, an exam (which the rule says may be given by the American Chiropractic Registry of Radiologic Technologists or the Tennessee Chiropractic Association) and 1,040 hours of clinical internship.Source: Rules 0260-03-.02 to .08; Board of Medical Examiners x-ray operator page. Checked October 4, 2026.
X-ray technologists’ continuing education: the board’s own sources disagree: Published Three board sources, read October 4, 2026, give two different numbers. The board’s home page says “Chiropractic x-ray operators and therapy assistants must complete six (6) hours annually.” The board’s rule for x-ray technologists says each certificate holder “must complete three (3) clock hours of continuing education each calendar year.” The board’s continuing-education policy, which it says “was revised and ratified by the Board on October 16, 2025,” says x-ray technologists “are required to complete three (3) clock hours” a year. For therapy assistants all three say six. We do not say which governs; if you hold this certificate, ask the board in writing.Source: board home page, continuing education section; Rule 0260-03-.12(1), revised July 2023; board continuing education policy, October 2025. Checked October 4, 2026.
The statute: Unverified Tennessee Code §§63-4-119 and 63-4-123, which the rules cite as their authority: not yet read — the official text requires accepting Lexis terms.

Pennsylvania

Pennsylvania State Board of Chiropractic · pa.gov board page

Does the board register, certify or license assistants?: Not published No. The credentials the board lists in 49 Pa. Code §5.11a are all for chiropractors. The Chiropractic Practice Act allows “unlicensed supportive personnel performing under the direct on-premises supervision of a licensed chiropractor.”Source: 49 Pa. Code Chapter 5; Chiropractic Practice Act §601; board page. Checked October 4, 2026.
Limits on what staff may do: Published A chiropractor “may not delegate any activity or duty to such unlicensed individuals which requires formal education or training in the practice of chiropractic.”Source: Chiropractic Practice Act §601. Checked October 4, 2026.
X-ray: Published Auxiliary personnel may take x-rays only if they have passed a radiography exam of the ARRT or ACRRT, or one approved by the chiropractic, medical or osteopathic board, with the chiropractor on the premises. The board’s special notice says it “will no longer register auxiliary personnel or issue any document authorizing them to administer ionizing radiation”; proof of the passed exam is kept by the assistant and the chiropractor.Source: 49 Pa. Code §§5.61–5.63; Act §522(a); board special notice on radiology personnel. Checked October 4, 2026.

Indiana

Indiana Board of Chiropractic Examiners · in.gov board page

Does the board register, certify or license assistants?: Not published No registration, certification, education or continuing-education requirement for assistants is published in the board’s rules (846 IAC Article 1) or on its pages checked. The statute lets an employee of a chiropractor perform acts within the employing chiropractor’s scope “under the direction and supervision of the employing chiropractor”.Source: IC 25-10-1-13; 846 IAC Article 1; board page. Checked October 4, 2026.
Limits on what staff may do: Published An employee who is not a chiropractor or physician “may not: (1) make a diagnosis or prescribe a treatment; or (2) manipulate, adjust, or mobilize the spinal column or vertebral column of an individual.”Source: IC 25-10-1-13(b). Checked October 4, 2026.
X-ray: Published Regulated by the Indiana Department of Health, not the chiropractic board. Its rule lists a “Limited chiropractic radiography license”; qualifying requires a department-approved limited chiropractic radiography program, a department-approved exam, and certification of proficiency.Source: 410 IAC 5.2-3-1 and 5.2-13-1. Checked October 4, 2026.Unverified Fees, the exam’s name and continuing education for this license. We read the rule, not the department’s licensing page.

Georgia

Georgia Board of Chiropractic Examiners · sos.ga.gov board page

Does the board register, certify or license assistants?: Not published No credential for assistants is published. The board has a rule titled “Chiropractic Assistants” that allows chiropractors to “utilize persons to assist them,” but it attaches no registration, education, exam or renewal to the role.Source: Rule 100-15-.01; board FAQ; board rules page. Checked October 4, 2026.
Limits on what staff may do: Published “Only licensed doctors of chiropractic shall be authorized to perform adjustments of the articulations of the human body.” An assistant works under the direct order and direct supervision of a chiropractor who is physically present in the office, and may administer modalities only under a chiropractor whom the board has certified to use them.Source: Rule 100-15-.01(a)–(c). Checked October 4, 2026.Unverified The statute the rule cites for modalities, O.C.G.A. §43-9-16(b): not yet read — the official text requires accepting Lexis terms. The board’s policies document did not open for us.
X-ray: Published The board’s FAQ points x-ray users to a Department of Community Health rule, which requires people operating a radiation machine to receive “at a minimum, six hours of instruction,” completed within 90 days of employment, with records kept. No separate state license for chiropractic x-ray staff appears on the pages checked.Source: board FAQ; Rule 111-8-90-.04(2)(a). Checked October 4, 2026.

Illinois

Illinois Department of Financial and Professional Regulation, which licenses chiropractic physicians under the Medical Practice Act · idfpr.illinois.gov

Does the board register, certify or license assistants?: Not published No. The license types IDFPR lists for this profession are chiropractic physician, visiting chiropractic physician and continuing-education sponsor. The Medical Practice Act lets a physician, a term that includes chiropractic physicians, “delegate patient care tasks or duties to an unlicensed person who possesses appropriate training and experience,” with a licensed health care professional on site.Source: IDFPR chiropractic page; 225 ILCS 60/2 and 60/54.2; 68 Ill. Adm. Code 1285. Checked October 4, 2026.
Limits on what staff may do: Published “No physician may delegate any patient care task or duty that is statutorily or by rule mandated to be performed by a physician.” The act says section 54.2 is scheduled to be repealed on January 1, 2032.Source: 225 ILCS 60/54.2. Checked October 4, 2026.
X-ray: Published The Illinois Emergency Management Agency accredits a “Chiropractic Radiographer,” defined as a person other than a licensed practitioner who applies x-radiation “for diagnostic evaluation of skeletal anatomy” under a chiropractor’s general supervision. The exam named is the American Chiropractic Registry of Radiologic Technologists (ACRRT). Renewal lists 24 continuing-education credits in chiropractic radiology.Source: 32 Ill. Adm. Code 401.20, 401.70 and 401.140. Checked October 4, 2026.Unverified The renewal period those 24 credits cover.

California

California Board of Chiropractic Examiners · chiro.ca.gov

Does the board register, certify or license assistants?: Not published No credential for assistants is published in the board’s regulations. Section 312 governs “unlicensed individuals,” meaning anyone without a California chiropractic license. The board’s July 23, 2026 meeting materials list a rulemaking item to amend §312 to “delineate the activities that can be performed by chiropractic assistants,” planned for discussion at its October 2026 meeting. As of October 4, 2026 the board’s proposed-regulations page says “None at this time.”Source: Board regulations, 16 CCR §312 (revised November 2021); July 23, 2026 board materials, item 16; proposed regulations page. Checked October 4, 2026.
Limits on what staff may do: Published “Unlicensed individuals are not permitted to diagnose, analyze, or perform a chiropractic adjustment.” They may take a history, conduct standard examinations under the immediate and direct supervision of a chiropractor on the premises, give physical therapy treatments under supervision, and mark x-ray films without drawing diagnostic conclusions.Source: 16 CCR §312(a)–(d). Checked October 4, 2026.
X-ray: Published Under §312(e), unlicensed individuals “may not administer X-rays unless they hold a valid X-ray technician certificate,” or are in an approved training program under direct supervision, and that includes positioning the patient and pushing the button. The certificate now comes from the California Department of Public Health’s Radiologic Health Branch, whose FAQ says it is “unlawful for you to take X-rays without a current valid certificate/permit.”Source: 16 CCR §312(e); CDPH Radiologic Health Branch FAQ; CDPH radiation health professionals page. Checked October 4, 2026.

Florida

Florida Board of Chiropractic Medicine · floridaschiropracticmedicine.gov

Does the board register, certify or license assistants?: Published Yes. The board certifies the “Certified Chiropractic Physician’s Assistant.”Source: board certification page. Checked October 4, 2026.
What it requires: Published One of: completing a program approved under Rule 64B2-18.003(2), F.A.C.; graduating from a chiropractic college accredited by or holding status with the Council on Chiropractic Education, with no disciplined chiropractic license anywhere; or completing 24 months of CCE-accredited chiropractic education. The board notes that House Bill 975, from the 2024 session, requires electronic fingerprinting for this profession.Source: board certification page. Checked October 4, 2026.
X-ray: Unverified Not checked for this page.

Alaska

Alaska Board of Chiropractic Examiners · Statutes and Regulations, Chiropractors (rev. March 13, 2025)

Does the board register, certify or license assistants?: Published The statute says “enrollment in or completion of a nationally recognized certification program” is required to practice as a chiropractic clinical assistant. The regulation names three ways to meet it: the Certified Chiropractic Clinical Assistant program administered by the Federation of Chiropractic Licensing Boards, the Chiropractic Therapy Assistant program administered by the Tennessee Chiropractic Association, or an equivalent program as determined by the board. A new hire has 12 months from the hire date.Source: AS 08.20.168 and 12 AAC 16.052(f). Checked October 4, 2026.
Limits on what staff may do: Published A chiropractic clinical assistant “may not provide chiropractic diagnosis, chiropractic adjustment … or formulation or alteration of treatment plans,” and must keep current CPR certification. Using the title “Certified Chiropractic Clinical Assistant” is restricted to people who have met the requirement.Source: 12 AAC 16.052(b), (c) and (h). Checked October 4, 2026.
X-ray: Published The statute lets a person who meets the certification requirement “perform diagnostic imaging studies” under a chiropractor’s general supervision.Source: AS 08.20.168(b). Checked October 4, 2026.

North Carolina

North Carolina Board of Chiropractic Examiners · ncchiroboard.com

Does the board register, certify or license assistants?: Published Yes, and it is required. The statute says a person employed as a chiropractic clinical assistant “shall obtain a certificate of competency from the North Carolina State Board of Chiropractic Examiners (Board) within 180 days after the person begins employment,” and that certification is not required for staff whose duties are “limited to administrative activities of a nonclinical nature.” The board’s rule sets two levels: Level 1 – Clinical and Level 2 – X-ray. Graduates of accredited chiropractic colleges and students on college-sponsored preceptorships are treated as meeting the requirements; if they work as clinical assistants for more than 180 days they still file the application, noting the exemption.Source: G.S. 90-143.4(b); 21 NCAC 10 .0213(a) and (h), readopted effective April 1, 2026. Checked October 4, 2026.
What it requires: Published At least 18 years old and a high school graduate or equivalent, with a $35 application fee. Level 1: “a clinical assistant education program at least 24 hours in length, of which at least 6 hours shall be in-person didactic training,” with no more than 18 hours online, then a board exam with a 75 percent passing score. Level 2 adds a radiological technologist program of at least 50 hours, supervised practical exams and a second board exam. Renewal is every two years, with six hours of continuing education for Level 1 and six more in radiologic technology for Level 2.Source: 21 NCAC 10 .0213(b)–(d) and (f). Checked October 4, 2026.
Limits on what assistants may do: Published The statute does not allow a clinical assistant “to provide a chiropractic adjustment, manual therapy, nutritional instruction, counseling,” or other services that require individual licensure.Source: G.S. 90-143.4(a). Checked October 4, 2026.
X-ray: Published The board’s FAQ: “all employees of a chiropractic office who perform activities involving the production of X-rays must complete Level II chiropractic assistant education.” Active registration with the American Chiropractic Registry of Radiologic Technologists satisfies the Level 2 education requirement only.Source: board FAQ; 21 NCAC 10 .0213(d)(1); G.S. 90-143.2. Checked October 4, 2026.

Oregon

Oregon Board of Chiropractic Examiners · oregon.gov/obce

Does the board register, certify or license assistants?: Published Yes. “A chiropractic assistant shall not perform direct patient care until they are certified by the OBCE.” Certification runs for 12 months.Source: OAR 811-010-0110(1) and (6), last amended effective February 4, 2025; ORS 684.054 and 684.155. Checked October 4, 2026.
What it requires: Published A board-approved course: “at least twelve hours in length, of which eight hours shall be didactic training and four hours shall be practical training,” completed within 60 days before applying; an open-book exam given by the National Board of Chiropractic Examiners; and age 18 or older. Six hours of continuing education a year. The board’s page lists “Total fees of $175” with the application.Source: OAR 811-010-0110(2), (5) and (13); board chiropractic assistant page. Checked October 4, 2026.
Limits on what assistants may do: Published The assistant must be directly supervised and “The supervising licensed chiropractic physician must be on the premises.” Assistants may provide physiotherapy, electrotherapy, hydrotherapy and vital signs, and may not “perform or provide physical examinations, take initial histories, interpret postural screening, perform manual muscle testing, or osseous adjustments or manipulations.”Source: OAR 811-010-0110(7)–(9). Checked October 4, 2026.
X-ray: Published “Chiropractic assistants must be licensed by the Oregon Board of Medical Imaging to perform x-rays.”Source: OAR 811-010-0110(10). Checked October 4, 2026.Unverified The Board of Medical Imaging’s own requirements for that license. Not yet read.

Arizona

Arizona State Board of Chiropractic Examiners · chiroboard.az.gov

Does the board register, certify or license assistants?: Published The statute defines a “chiropractic assistant” as “an unlicensed person who has completed an educational training program approved by the board,” and directs the board to adopt rules on their qualifications. It is unlawful to “Work as a chiropractic assistant except under the supervision of a doctor of chiropractic” under the chapter and the board’s rules.Source: A.R.S. 32-900(4); A.R.S. 32-904; A.R.S. 32-926(A). Checked October 4, 2026.Unverified Blocked. The training hours, any registration step and fees are in the board’s rules (A.A.C. R4-7-1101 to R4-7-1103). The official rules file and the board’s website did not open for us; we state nothing from them.
Limits on what assistants may do: Published A chiropractic assistant may not do “the chiropractic specialty of acupuncture by needle insertion.”Source: A.R.S. 32-930. Checked October 4, 2026.
X-ray: Published Arizona’s radiation law says “a person may not use ionizing radiation on a human being unless the person is a licensed practitioner or the holder of a certificate as provided in this chapter,” and it defines a “practical technologist in radiology certificate” for people other than licensed practitioners.Source: A.R.S. 32-2811(A); A.R.S. 32-2801(16). Checked October 4, 2026.Unverified We found no board or agency statement on how this applies to chiropractic assistants, so we state no requirement.

Louisiana

Louisiana State Board of Chiropractic Examiners · lachiropracticboard.com

Does the board register, certify or license assistants?: Not published No general assistant credential is published in the chiropractic statute or the board’s rules. The board certifies x-ray work only (below).Source: LAC 46:XXVII; board home page. Checked October 4, 2026.
X-ray: Published “Each chiropractic assistant who engages or attempts to engage in the taking of chiropractic x-rays in this state shall be certified as to their proficiency by the Louisiana Board of Chiropractic Examiners.” The applicant must be 18, a high school graduate or equivalent, and have “completed a course in x-ray function and safety approved by the board, including passage of a proficiency examination given in conjunction with the course.” Holders register with the board every year by July 31. The board may also certify people certified by the American Chiropractic Registry of Radiologic Technologists.Source: La. R.S. 37:2828; La. R.S. 37:2829; LAC 46:XXVII.317. Checked October 4, 2026.Unverified Which x-ray courses the board has approved. No list appears on the board pages we could read.

Washington

Chiropractic Quality Assurance Commission, Department of Health · doh.wa.gov

Does the board register, certify or license assistants?: Not published No credential for general assistants, whom the rules call “auxiliary staff.” A chiropractor “may delegate certain services to auxiliary staff” under direct supervision.Source: WAC 246-808-510; WAC 246-808-535(1); Department of Health chiropractic page. Checked October 4, 2026.
Limits on what assistants may do: Published Auxiliary staff may not detect subluxations, adjust or manipulate, interpret or analyze radiographs, determine the need for care, or perform orthopedic or neurological exams.Source: WAC 246-808-535(2). Checked October 4, 2026.
X-ray: Published A separate registration: “A chiropractor may employ a technician to operate X-ray equipment after the technician has registered with the commission.” The rule requires a commission-approved course “of not less than 72 classroom hours, 30 of which are in-person learning,” and a written and practical exam. The Department of Health lists a $182 initial application.Source: RCW 18.25.180(1); WAC 246-808-205; Department of Health license requirements page. Checked October 4, 2026.

Colorado

Colorado State Board of Chiropractic Examiners · dpo.colorado.gov/Chiropractic

Does the board register, certify or license assistants?: Not published No registration, certificate or license. The board’s rule says “Appropriate training may be determined by the supervising chiropractor,” and makes the chiropractor responsible for keeping records of the assistant’s training.Source: 3 CCR 707-1, Rule 1.18(E), effective September 14, 2025; board laws and rules page. Checked October 4, 2026.
Limits on what assistants may do: Published The board’s posted copy of the statute says a chiropractor “may supervise up to five unlicensed persons as chiropractic assistants,” and “A chiropractic assistant shall not perform a diagnosis, an adjustment, or acupuncture.”Source: C.R.S. 12-215-128, board-posted uncertified printout. Checked October 4, 2026.Unverified The official statute text: not yet read — the official text requires accepting Lexis terms. The quotation above is from the copy the board posts.
X-ray: Published Unlicensed staff must complete a board-approved course before operating x-ray equipment: five hours of basic radiological guidelines, five of operator and patient safety, and 14 of practical and clinical experience. The employing chiropractor keeps the written verification. The state health department says x-ray operation in chiropractic “requires training specified by each respective board.”Source: 3 CCR 707-1, Rule 1.18(B)–(D); Department of Public Health and Environment x-ray operator page. Checked October 4, 2026.

Minnesota

Minnesota Board of Chiropractic Examiners · mn.gov/boards/chiropractic

Does the board register, certify or license assistants?: Not published No assistant credential in the chiropractic statute or the board’s rules. The statute says it is not a violation for a chiropractor “to employ, supervise, or delegate functions to a qualified person who may or may not be required to obtain a license or registration.”Source: Minn. Stat. 148.10, subd. 1(a)(13); Minn. R. chapter 2500. Checked October 4, 2026.Unverified Blocked. The board’s own website did not open for us, so any FAQ or policy it publishes on assistants is unchecked.
Limits on what assistants may do: Published Therapeutic services “must be rendered under the direct supervision of qualified staff,” and the rules define qualified staff as “a person who has specific training in an area of rehabilitative therapy.” No hours, exam or issuer are set.Source: Minn. Stat. 148.01; Minn. R. 2500.0100, subp. 10. Checked October 4, 2026.
X-ray: Published The Department of Health requires anyone other than the licensed practitioner to pass an exam before operating x-ray equipment. Its course list says “Chiropractic Assistants must take the Minnesota Limited Scope X-ray Operator examination.” The statute also accepts the American Chiropractic Registry of Radiologic Technologists exam, limited to spines and extremities.Source: Minn. Stat. 144.121, subd. 5; Minn. R. 4732.0570; Department of Health course list. Checked October 4, 2026.

Michigan

Michigan Board of Chiropractic, Department of Licensing and Regulatory Affairs · michigan.gov

Does the board register, certify or license assistants?: Not published No assistant credential in the chiropractic rules. Delegation runs through the general health code: a licensee may delegate to an unlicensed individual “who is otherwise qualified by education, training, or experience,” but not tasks requiring the licensee’s own level of education, skill and judgment.Source: Chiropractic General Rules, R 338.12001–338.12054; MCL 333.16215(1); board page. Checked October 4, 2026.
X-ray: Published The state’s radiation rules require people doing limited diagnostic radiography to “pass an approved program or obtain a minimum of 40 hours of training” within that scope. The Department of Labor and Economic Opportunity’s FAQ says “a license is not required, and a licensing program is not anticipated,” that noncompliance falls on the facility, and “You must complete the 40 hours training before March 13, 2027.”Source: R 333.5212(1); x-ray operator qualification FAQ. Checked October 4, 2026.

Ohio

State Chiropractic Board of Ohio · chirobd.ohio.gov

Does the board register, certify or license assistants?: Not published No credential. The board’s rule covers “Unlicensed supportive personnel,” and “It is the licensee’s responsibility to ensure that unlicensed supportive personnel are competent and properly qualified by education, training, and/or experience to perform their assigned tasks and duties.”Source: OAC 4734-8-02(A) and (C), effective December 25, 2025. Checked October 4, 2026.
Limits on what assistants may do: Published The rule lists the tasks that may be delegated, only with a licensed chiropractor on site, including vital signs, heat and cold, traction, electrical stimulation and therapeutic ultrasound. Therapeutic procedures exclude “manual therapy or massage therapy techniques.”Source: OAC 4734-8-02(D). Checked October 4, 2026.
X-ray: Published The state radiologic licensing law says no person shall practice as a “general x-ray machine operator” without a license, exempts the chiropractor personally, and lets a licensed operator perform procedures only with a physician, podiatrist, mechanotherapist or chiropractor “providing direct supervision.” The Department of Health lists an accredited classroom program, a $140 exam, an accredited clinical program and a $65 application.Source: ORC 4773.02 and 4773.06; Department of Health operator requirements. Checked October 4, 2026.

Arkansas

Arkansas State Board of Chiropractic Examiners · healthy.arkansas.gov

Does the board register, certify or license assistants?: Not published No credential for the role, which the statute calls a “chiropractic aide”: an unlicensed member of the team who may assist the chiropractor “with the exception of spinal manipulation and adjustment.”Source: A.C.A. 17-81-102(4), as printed in the board’s statutes and rules compilation dated February 10, 2021. Checked October 4, 2026.Unverified The official statute text: not yet read — the official text requires accepting Lexis terms. Whether the 2021 compilation is still the current rule text is also unchecked.
Limits on what assistants may do: Published “The chiropractic aide may not render any diagnosis, submit treatment plans to patients, or in any other way assume responsibility for the management of patient care.” The board’s FAQ says the doctor “must be on the premises at all times.”Source: Board rule 007.33.8-2-E(2)(a); board FAQ. Checked October 4, 2026.
X-ray: Published The board’s rule: “Chiropractic aides must obtain a Radiologic Technology License through the Arkansas Department of Health to perform x-rays,” and offers certification through the American Chiropractic Registry of Radiological Technologists “In lieu of” that license. The board’s FAQ refers only to the Department of Health’s requirements and does not mention the registry.Source: Board rule 007.33.8-2-E(2)(d)–(e); board FAQ. Checked October 4, 2026.Unverified Whether the Department of Health accepts the registry certification. Its rule and FAQ files did not open for us.

Connecticut

Connecticut State Board of Chiropractic Examiners, Department of Public Health · portal.ct.gov

Does the board register, certify or license assistants?: Not published Nothing on assistants or unlicensed staff in the chiropractic statute, the board’s page or the licensure requirements page.Source: CGS chapter 372; board page; licensure requirements page. Checked October 4, 2026.
X-ray: Published The radiographer licensing law says “No person shall operate a medical x-ray system unless such person has obtained a license as a radiographer from the department,” and that a licensed radiographer may operate one under the order of a chiropractor, among others.Source: CGS 20-74bb(a) and (b). Checked October 4, 2026.Unverified How this applies to chiropractic office staff. We found no board or Department of Public Health statement on it, so we state no requirement.

Missouri

Missouri State Board of Chiropractic Examiners · pr.mo.gov

Does the board register, certify or license assistants?: Not published Nothing on assistants, unlicensed staff or delegation in the chiropractic statute, the board’s rules or its website.Source: RSMo chapter 331; 20 CSR 2070-2; board pages. Checked October 4, 2026.
X-ray: Not published The board’s x-ray rule is listed as “Rescinded October 30, 2019,” and the health department’s radiation rule regulates the equipment, not the operator.Source: 20 CSR 2070-2.025; 19 CSR 20-10. Checked October 4, 2026.

Alabama

Alabama State Board of Chiropractic Examiners · chiro.alabama.gov

Does the board register, certify or license assistants?: Not published No credential. The board’s rules mention a chiropractic assistant only once, as a measure of what a student extern may do. A licensee may not delegate to someone the licensee knows or has reason to know “is not qualified by training, experience or licensure to perform them.”Source: Board rules, March 2026, 190-X-7-.02 and 190-X-5-.11; board statute compilation. Checked October 4, 2026.
X-ray: Published The Department of Public Health: “Alabama does not currently require a license to operate a medical use x-ray machine.” Operators must be instructed in safe operating procedures.Source: Office of Radiation Control FAQ. Checked October 4, 2026.

Not yet checked

We have not yet read the board pages for the states and jurisdictions below, so this page says nothing about them. That is not the same as “no requirement.” Find your board through your state’s professional licensing agency and read what it publishes about unlicensed staff, assistants and x-ray operators.

Delaware
District of Columbia
Hawaii
Idaho
Iowa
Kansas
Kentucky
Maine
Maryland
Massachusetts
Mississippi
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Dakota
Oklahoma
Puerto Rico
Rhode Island
South Carolina
South Dakota
Utah
Vermont
Virginia
West Virginia
Wisconsin
Wyoming

What this page does not cover

Employer requirements. An office can require a certificate the state does not. That is a hiring decision, not a state rule.
Other agencies. X-ray work in particular is often regulated outside the chiropractic board, as Indiana, Illinois, California, Minnesota, Michigan and Ohio show. We note what we found, but we have not checked every radiation-control agency.
Course approval. Where a board approves training, it says so in its rules. A course provider saying it is “approved” or “recognized” is not the same thing. How to check whether a certificate counts in your state.

Keep going

Which certification do you need?

How to get the answer from your state board, not a course provider.

The chiropractic assistant role

What the job involves, the titles it goes by, and how people train.

From assistant to doctor

The full path to becoming a chiropractor.

FAQ

Is there a national chiropractic assistant license?

No. Chiropractic assistants are regulated, if at all, state by state. Of the 22 states we have checked, Tennessee, Florida, North Carolina and Oregon certify an assistant role through their own boards, Alaska requires a nationally recognized certification program, and Arizona's statute defines a chiropractic assistant as someone who has completed a board-approved training program. Louisiana certifies x-ray work only, and Washington registers chiropractic x-ray technicians. The rest publish no assistant credential, though most set limits on what unlicensed staff may do. Checked October 4, 2026.

Do I need a certificate to work as a chiropractic assistant in Texas?

The Texas Board of Chiropractic Examiners publishes no registration, certification or license for assistants. Its rule lets a chiropractor delegate certain acts to a qualified individual, defined as an unlicensed individual with adequate education, training and skill, and the chiropractor must document that the person is qualified. Diagnosis, treatment plans and adjustments cannot be delegated. Checked October 4, 2026.

What does Tennessee require for a chiropractic therapy assistant?

Tennessee's Board of Chiropractic Examiners requires certification before you practice as a chiropractic therapy assistant. The rules require at least 50 hours of board-approved instruction, a board examination, and 1,200 hours of supervised clinical internship, plus six hours of continuing education a year. X-ray work needs a separate certificate as a chiropractic x-ray technologist. Checked October 4, 2026.

Can a chiropractic assistant take x-rays?

It depends on the state, and x-ray work usually has its own rule, often from a different agency than the chiropractic board. Among the states we checked, Tennessee, North Carolina and Louisiana certify x-ray work through the chiropractic board, Washington registers chiropractic x-ray technicians, Oregon requires a Board of Medical Imaging license, Indiana a limited chiropractic radiography license, Illinois accreditation as a chiropractic radiographer, Minnesota a state exam, and California a state certificate or permit. Colorado and Michigan set training hours, and Alabama requires no operator license. Each state's entry links its source.

What does it mean when a state says not yet checked?

It means we have not read that state's board pages yet, so we say nothing about it. It does not mean the state has no requirement. Read your own board's pages on unlicensed staff and x-ray operators, or ask the board directly.

Chiropractic assistant requirements by state