Become a Member
Levels of OKAA membership (application form below) 

Certified Member:
A one-time fee of $125 covers your application fee.  If approved this will certify you for 1 year as a member who has applied for and met criteria set forth by the OKAA as standards of care within the State of Oklahoma. Certified members are required to maintain continuing educational hours, that is not limited to certification in CPR. Level one members attend regular meeting and have voting privileges. The annual renewal fee is $50. You can be a certified member if you are NCCAOM certified or if you have one of the following:

Route of Formal Acupuncture:
Education 850 hours from any NACSACAOM or state licensed vocationaland/or approved acupuncture school in the United States.

Route of Apprenticeship:
2000 hours professional practice with an approved preceptor, eitherNCCAOM Board certified or OKAA certified practitioner of acupuncture.

Route of Previous Practice:
Two (2) years of professional practice with 500 documented patient visits yearly.


  General Member :
This level member is a practitioner of natural healing in some way, up to and including being an acupuncturist, but elects not to be a certified member.  General members attend regular meeting and have voting privileges.  The membership fee is $50, and remains as $50 annual renewal fee.
 
Student Members:
Student members are listed only under the school that they are studying under.  Student members attend regular meeting and do not have voting privileges. The membership fee for students is $35.00.
 
Friends of Acupuncture:  
This level of membership is for private individuals who support the actions of the OKAA and are invited to its quarterly business and educational meetings. The membership fee at this level is $15.

Members can renew their membership at the certified level only if submitting the required continuing education hours and CPR documentation. If a member fails to meet these requirements in a given year, they may (without penalty) renew the following year at the “certified member” level if continuing education hours and CPR certification is met at that time.

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OKAA Membership Form (print page and mail in or cut and paste and email)

Fill out and send by December of the current year to join for the following year.  We do not track this for you, so please add to your calendar.

Attachments:
____ Copy of a current CPR card (both sides)
____ Two forms of identification. One must be a current government-issued photo ID. The other must bear your signature.
____ Passport sized photo
____ Official transcripts from any schools/colleges
____ Copy of all related licenses and certifications
____ One letter of recommendation from teachers or employers supporting this application.
____ $50.00 Renewal fee (check or money order) for regular or certified member renewals.
____ Completed form below

____ $125 (non-refundable) if this is your first time to register as a certified member.  Regular members and renewals need not pay this fee. Receipt of application does NOT guarantee your eligibility of certification.

If you are certified or certifying, you must also include the following:
____ Continuing Education: A minimum of 15 hours of continuing education hours; At least 10 in core Acupuncture topics and the remaining 5 in any collateral
Health Care topics are required annually.

If you are a student member only:
____ $15 annual fee

General Membership and Renewals Mail to:
OKAA
2517 W Kent street

Broken Arrow, OK 74012

New Members for Certification send to:
Dr.Yang OKAA
1921 NW 23rd St
Oklahoma CIty, OK 73106

Name:_____________________________________________________________


Address:_____________________________________________________City_________________________State:________________Zip Code__________

email:_____________________________________________________________Phone#:________________________________________________________

SS#: _______________________________________________________ Date of Birth: _______________________________________________________


BusinessName:_____________________________________________________Web Site:_____________________________________________________

Place of Birth: _____________________________________________ Gender: ______________________________________________________________

For the OKAA Website, each member is given two lines to list any specialty Field they perform. If you would like any additional information about yourself
or yourclinic mentioned on the website, please print clearly on the following lines.

_______________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________

Route Of Eligiblitity: __________________________________________________________________________________________________

Formal Education (Please Check): __________Pre-graduate _________________Graduate _____________State License Holder

______________NCCAOM Certified __________________Other Certification (Please list any explanations below): ___________

________________________________________________________________________________________________________________________

Legal Status: You must furnish additional information with this application if you answer "yes" to any of the following questions. THis documentation must include your explanation of the charges or claims made against you, all legal documents related to the charges or claims and an account of how the charges or claims were resolved. If a case is still pending, please indicate that fact in your response. All information provided will be reviewed in accordance with OKAA policies.
1. Have you ever been a defendant in litigation related to the practice of a health-related profession? ________________
2. Has a judgment ever been entered against you or have you been a party to a settlement in any legal proceeding relevant to the practice of a health-related profession? ________________________________________________________________
3. Have you ever been convicted of a felony? ___________________________________________________________________________
4. Have you ever been convicted of any other crime relevant to the practice of a health related profession? ___________
5. Have you ever had any disciplinary or administrative action or order taken against you by any licensing board or health-related professional association or school? _____________________________________________________________________
6. Have you ever been denied or voluntarily surrendered a license to practice in any health-related profession? ______

Health Status: If you answer yes to any of the following questions, you must furnish with your application information about any impairment from a healthcare professional who has treated you. THis documentation must include a personal statement of the history and current status of any physical or psychological impairment or impairment due to substance abuse and an attestation that you are no longer impaired (or that you are currently under treatment for the impairment) and that the impairment or treatment does not interfere with your ability to practice.
1. Has your physical or psychological health status interefered with your ability to practice a health related profession or othersie interrupted your professional or academic activities for more than 3 months? _________________
2. Have you ever been, or are you currently impaired becasue of any substance abuse, including alcohol? _____________

You are required to notify the OKAA within 30 days of any changes to the inforamtion you have supplied in this section on Professional Ethics and Fitness to Practice.

CPR status (Health Care Provider level certification required): ________________________________________________________________
Please include a photo copy of your most recent CPR card. Make sure to include copies of both front and back of card.

CEU's (for certified members only) for current year:
A minimum of 15 hours of continuing education hours; At least 10 in core Acupuncture topics and the remaining 5 in any collateral
Health Care topics



Date Attended                Hours                             Topic

______________               _________________        ________________________________________________________________________

______________               _________________        ________________________________________________________________________

______________               _________________        ________________________________________________________________________

______________               _________________        ________________________________________________________________________

______________               _________________        ________________________________________________________________________

______________               _________________        ________________________________________________________________________

List Occupational/Professional Licesnses or Certifications: (state/county of issue, license #, expiration date)

_______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

Professional Acupuncture History: ___________________________________________________________________________________

_______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

Statement of Acknowledgement: Your signature below must be notarized.

I hereby certify that the information I provided on this application and in any supporting document is accurate, true and correct to the best of my knowledge and belief. I acknowledge and agree to abide by and with the plicies, procedures, and Code of Eithics promulgated and/or modified from time to time by OKAA. I agree to inform and release to OKAA and its designated agents all pertinent information about my qualifications or about other matters that may arise in connection with my application and/or my subsequent certification or recertification by OKAA. I acknowledge and agree that my failure to comply, or to report any pertinent information regarding this application may result in my certification being revoked in accordance with OKAA policies and procedures andor legal action, up to and including criminal prosecution. I acknowledge that application fees are non-refundable.

Applicant's Notarized Signature:

_______________________________________________________________________         Date: _____________________________________

Signature and Seal of Notary Public:





Please attach any additional information.