Forms

Be sure to view/download the most recent version of all Commission resources. Due to the ACAHM name change in progress, most documents will be updated over the next several weeks. Some updates may be substantive, as content updates were previously scheduled.

The following forms and applications are used by programs, institutions and the general public to initiate various processes with the Commission.  Forms are in PDF format unless otherwise mentioned:

DOCUMENT SUBMISSIONS

ACAHM Document Submission Instructions [3 February 2022]

PDF document of instructions for how to submit documents to ACAHM.

Attestation/Signature Page for Self Study and Other Reports [17 March 2021]

Contains required attestations and signatures for Self Study, Progress, Monitoring, Supplemental and other reports; PDF document.

Attestation/Signature Page for Notification of Change Submissions [17 March 2021]

Contains required attestations and signatures for substantive change applications and other notifications of change; PDF document.

NOTIFICATION OF CHANGE

Please carefully review the Notification of Change Policy prior to submission of any of the following forms or applications.  Please follow the Document Submission Instructions as appropriate for your particular submission.  Be sure to complete the Attestation/Signature Page for Notification of Change Submissions and include it with your submission.  NOTE: Most of the change-related forms below are in DOCX format.

Change Notification Form

Use the Change Notification Form if you are unsure about which type of Change Notification should be submitted, or if there is no corresponding form available

1.01/1.02/1.03: Changes in Location/New Locations

Use this application if you are submitting a notification of change related to one of the following:  1.01A change in location of a main campus, branch campus or additional location; 1.02: The addition of a location offering 50% or more of an ACAOM accredited program; or 1.03The establishment of a branch campus.

1.04: Acquisition of AOM Program or Institution

Use this application if you are submitting a notification of change related to 1.04: The acquisition of any other AOM institution or any AOM program or location of another institution that offers 50% or more of an AOM program.

1.05/1.06/1.07/1.08: Addition of New Programs [4 February 2022]

Use this application if you are submitting a notification of change related to one of the following:  1.05: The addition of a Master of Acupuncture (MAc) degree program by an institution that offers an accredited Master of Acupuncture with Chinese herbal medicine specialization (MAcCHM) degree program; 1.06: The addition of a Master of Acupuncture with Chinese herbal medicine specialization (MAcCHM) degree program by an institution that offers an accredited Master of Acupuncture (MAc) degree program; 1.07:The offering of an ACAHM-accreditable program in a language other than English; or 1.08: The addition of an EAM doctoral program [e.g., addition of post-graduate Doctor of Acupuncture and Oriental Medicine (DAOM), Doctor of Acupuncture (DAc), Doctor of Acupuncture with Chinese herbal medicine specialization (DAcCHM)].

1.11: Change in Mission, Legal Status, Form of Control, or Ownership

Use this application if you are submitting a notification of change related to 1.11: Any change in the institutional mission, legal status, form of control, or ownership of an institution.

1.12: Ceasing Operations/Closing Location or Program

Use this application if you are submitting a notification of change related to 1.12: A decision to cease operations, close an institution, close a branch campus, close an additional
location, close a program, or propose a teach-out of students.

1.14: Contracting with Title IV-ineligible Institutions or Organizations

Use this application if you are submitting a notification of change related to 1.14: Entering into a contract with another institution or organization that is not certified to participate in Title IV, HEA programs and this institution/organization is contracting to offer more than twenty-fiveĀ (25) percent of one or more of the ACAOM-accredited institution’s educational programs.

COMPLAINT REVIEW

ACAOM Complaint Form [DOCX format]

For submission of complaints regarding programs and institutions accredited or pre-accredited by ACAOM, or regarding the Commission. Please carefully review the Complaint Review Policy before submitting this form

DISCLOSURES

Conflict of Interest Disclosure Form

For use in conjunction with the Conflict of Interest and Disclosure Policy

WAIVERS

ACAOM Waiver Request Form

For submission of a waiver by ACAOM-accredited or pre-accredited programs and institutions. Please carefully review the Waiver Policy before submitting this form