← The business of practice, every jurisdiction · Washington licensure
What Washington’s statute, administrative rules and chiropractic board publish on eight topics of running a practice, quoted as published, each with its citation as printed, its source and the date we read it. Read on 9 October 2026.
Advertising · Titles and claims · Prepaid care and financial arrangements · Discounts, free services and inducements · Record retention · Assistants and delegation · Corporate practice and ownership · Telehealth
(1) A chiropractor shall not, on behalf of himself/herself, his/her partner, associate or any other chiropractor affiliated with his/her office or clinic, use or allow to be used, any form of public communications or advertising which is false, fraudulent, deceptive or misleading, including, but not limited to, such advertising which takes any of the following forms which are prohibited:WAC 246-808-600 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(a) Advertising which guarantees any result or cure;WAC 246-808-600 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(b) Advertising which makes claims of professional superiority;WAC 246-808-600 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
Except as provided in RCW 18.130.450 , the following conduct, acts, or conditions constitute unprofessional conduct for any license holder under the jurisdiction of this chapter:RCW 18.130.180 · app.leg.wa.gov · default.aspx?cite=18.130.180 · read 9 October 2026
(2) A chiropractor shall, upon request made by the commission, provide the commission with substantiation of the truth and accuracy of any and all claims made in their advertisements.WAC 246-808-600 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(1) If a chiropractor advertises a fee for a service, the chiropractor must render that service for no more than the fee advertised.WAC 246-808-605 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(c) Advertising which fails to differentiate chiropractic care from all other methods of healing;WAC 246-808-600 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(3) All advertising which is false, fraudulent, or misleading;RCW 18.130.180 · app.leg.wa.gov · default.aspx?cite=18.130.180 · read 9 October 2026
On all cards, books, papers, signs or other written or printed means of giving information to the public, used by those licensed by this chapter to practice chiropractic, the practitioner shall use after or below his or her name the term chiropractor, chiropractic physician, D.C., or D.C.Ph.C., designating his or her line of drugless practice, and shall not use the letters M.D. or D.O.: PROVIDED, That the word doctor or "Dr." or physician may be used only in conjunction with the word "chiropractic" or "chiropractor".RCW 18.25.090 · app.leg.wa.gov · default.aspx?cite=18.25&full=true · read 9 October 2026
(1) When using their name, a licensed chiropractor must clearly identify oneself as a chiropractor on their office signs, website, business cards, letterhead, electronic and other media with the use of one or more of the following: Doctor of chiropractic; D.C.; D.C., Ph.C.; chiropractor; or chiropractic physician consistent with RCW 18.25.090 .WAC 246-808-520 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(2) A chiropractor shall identify and present their chiropractic practice in a dignified manner, and not in a sensational or misleading way.WAC 246-808-520 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(3) A chiropractor practicing in a multidisciplinary setting must identify oneself as a chiropractor.WAC 246-808-520 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(4) Nothing in this section prohibits the use of a business name that does not include one of the terms in subsection (1) of this section.WAC 246-808-520 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(1) In addition to those acts defined in chapter 18.130 RCW, the term "unprofessional conduct" as used in this chapter includes failing to differentiate chiropractic care from any and all other methods of healing at all times.RCW 18.25.112 · app.leg.wa.gov · default.aspx?cite=18.25&full=true · read 9 October 2026
It shall be considered unprofessional conduct for any chiropractor to enter into a contract which would obligate a patient to pay for care to be rendered in the future, unless the contract provides that the patient is entitled to a complete refund for any care not received.WAC 246-808-550 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
Any chiropractor who ceases practice in their community for any reason, including retirement, illness, disability, or relocation shall comply with the following duties:WAC 246-808-655 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(3) The chiropractor shall refund any part of fees paid in advance that have not been earned.WAC 246-808-655 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(1) A chiropractor shall not enter into an agreement for, charge, or collect an illegal or clearly excessive fee.WAC 246-808-400 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(2) When a chiropractic service is represented in public advertising as available without cost, or at a reduced cost, that service must be made available to everyone who wishes to take advantage of the offer on an equal basis. No charge may be made to any individual or third-party health care payor for any services which have been provided on a free basis.WAC 246-808-630 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(4) Billings to patients or to third-party health care payors shall accurately reflect the actual charge to the patient, including any discounts, reduced fees, or waiver of copayment.WAC 246-808-630 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(5) Because of the potential element of fraud being present, advertising full or partial forgiveness of coinsurance shall be prohibited unless the insurance company is given accurate and complete information relating to the actual charge to the patient and that coinsurance has been fully or partially waived.WAC 246-808-630 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
The following acts shall constitute grounds for which disciplinary action may be taken:WAC 246-808-545 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(1) Rebating or offering to rebate to an insured any payment to the licensee by the third-party payor of the insured for services or treatments rendered under the insured's policy.WAC 246-808-545 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
All offers of free X-rays shall be accompanied by a disclosure statement that X-rays shall only be taken if clinically necessary in order to avoid unnecessary radiation exposure.WAC 246-808-585 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
The acceptance directly or indirectly by any person so licensed of any rebate, refund, commission, unearned discount, or profit by means of a credit or other valuable consideration whether in the form of money or otherwise, as compensation for referring patients to any person, firm, corporation or association as set forth in RCW 19.68.030 , constitutes unprofessional conduct.RCW 19.68.020 · app.leg.wa.gov · default.aspx?cite=19.68&full=true · read 9 October 2026
(1) Nothing in this chapter may be construed to limit or prohibit the donation of electronic health record technology or other activity by any entity, including a hospital licensed under chapter 70.41 RCW that operates a clinical laboratory, when the donation or other activity is allowed by or otherwise does not violate, 42 U.S.C. Sec. 1320a-7b(b) or the federal rules adopted to implement 42 U.S.C. Sec. 1320a-7b(b).RCW 19.68.900 · app.leg.wa.gov · default.aspx?cite=19.68&full=true · read 9 October 2026
(1) Any chiropractor who treats patients in the state of Washington shall maintain all treatment records regarding patients treated. These records may include, but shall not be limited to, X-rays, treatment plans, patient charts, patient histories, correspondence, financial data, and billing. These records shall be retained by the chiropractor for five years in an orderly, accessible file and shall be readily available for inspection by the commission or its authorized representative: X-rays or copies of records may be forwarded pursuant to a licensed agent's written request. Also, office records shall state the date on which the records were released, method forwarded and to whom, and the reason for the release. A reasonable fee may be charged the patient to cover mailing and clerical costs.WAC 246-808-650 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(2) A chiropractor shall honor within fifteen days a written request from an adult patient or their legal representative or the legal representative of a minor child to release:WAC 246-808-650 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(a) Original X-rays and records to other licensed health care providers; orWAC 246-808-650 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(b) The chiropractor may provide duplicate films or a copy of the patient records to the health care provider or the patient. The health care provider may bill the patient reasonable duplication costs. Once the original films have been loaned at patient request, the chiropractor is no longer responsible for them, or for their retrieval or subsequent production.WAC 246-808-650 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
A chiropractor who has received original X-rays on a loan basis shall return them to the loaning chiropractor upon request within sixty days unless other arrangements are made.WAC 246-808-650 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
Any chiropractor who ceases practice in their community for any reason, including retirement, illness, disability, or relocation shall comply with the following duties:WAC 246-808-655 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(2) The chiropractor shall offer to deliver to the patient, or to another chiropractor or licensed health care professional chosen by the patient, the originals or copies of all patient examination and treatment records and X-rays or notify the patient of a community area location where the records and X-rays shall be maintained and accessible for at least one year after the notice is sent to the patient.WAC 246-808-655 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
A health care provider shall maintain a record of existing health care information for at least one year following receipt of an authorization to disclose that health care information under RCW 70.02.040 , and during the pendency of a request for examination and copying under RCW 70.02.080 or a request for correction or amendment under RCW 70.02.100 .RCW 70.02.160 · app.leg.wa.gov · default.aspx?cite=70.02.160 · read 9 October 2026
"Auxiliary staff" means personnel, except regular senior students and clinical postgraduate trainees, who receive ongoing on-the-job training and who work for or at the direction of a licensed doctor of chiropractic.WAC 246-808-510 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
"Direct supervision" and "direct supervision and control" means a licensed chiropractor is on the premises and immediately available, and has examined the patient prior to delegating duties to auxiliary staff, regular senior students, or clinical postgraduate trainees.WAC 246-808-510 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(1) A licensed chiropractor may delegate certain services to auxiliary staff, regular senior students, and clinical postgraduate trainees, if these services are performed under the licensed chiropractor's direct supervision and control. The supervising chiropractor shall be responsible for determining that auxiliary staff, regular senior students, and clinical postgraduate trainees are competent to perform the delegated services. The licensed supervising chiropractor must render adequate supervision so that the patient's health and safety is not at risk.WAC 246-808-535 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(2) Auxiliary staff shall not perform the following services:WAC 246-808-535 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(b) Adjustment or manipulation of the articulations of the body;WAC 246-808-535 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(5) Auxiliary staff, regular senior students, and clinical postgraduate trainees may perform the following auxiliary services: Preliminary patient history, height, weight, temperature, blood pressure, pulse rate, gross postural observation, active spinal range of motion utilizing a generally accepted measuring device, and oversight of patients during approved therapeutic procedures, rehabilitation exercises or use of therapeutic or rehabilitation equipment as incident to chiropractic services.WAC 246-808-535 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
(1) A licensed chiropractor shall employ only chiropractors or chiropractic X-ray technicians to operate X-ray equipment.WAC 246-808-205 · app.leg.wa.gov · default.aspx?cite=246-808&full=true · read 9 October 2026
While the rulemaking process is ongoing, the Commission is adopting this Policy Statement to make clear that, although inconsistent with the current rules, a regular senior student in an accredited and approved school of chiropractic may administer a chiropractic adjustment if the student has submitted a completed application with the Commission and passed the Commission’s jurisprudence examination.Policy Statement Number: CH-9-12-19 · doh.wa.gov · CH-9-12-19 -SeniorStudentsandPreceptorships.pdf · read 9 October 2026
The commission doesn't have jurisdiction over business models.Chiropractor, Chiropractic X-Ray Technician - Frequently Asked Questions (no section number printed) · doh.wa.gov · frequently-asked-questions · read 9 October 2026
Chiropractors should seek legal counsel about corporate practice of medicine prohibitions and the Professional Services Corporation Act (PSCA) in RCW 18.100 .Chiropractor, Chiropractic X-Ray Technician - Frequently Asked Questions (no section number printed) · doh.wa.gov · frequently-asked-questions · read 9 October 2026
However, if an unlicensed person interferes with a chiropractor's practice of the profession, it may constitute unlicensed practice under RCW 18.130.190 .Chiropractor, Chiropractic X-Ray Technician - Frequently Asked Questions (no section number printed) · doh.wa.gov · frequently-asked-questions · read 9 October 2026
The secretary of health has jurisdiction over the unlicensed practice of chiropractic.Chiropractor, Chiropractic X-Ray Technician - Frequently Asked Questions (no section number printed) · doh.wa.gov · frequently-asked-questions · read 9 October 2026
As stated above, you should seek legal counsel concerning the PSCA and professions that may set up professional service corporations together.Chiropractor, Chiropractic X-Ray Technician - Frequently Asked Questions (no section number printed) · doh.wa.gov · frequently-asked-questions · read 9 October 2026
(1) An individual or group of individuals duly licensed or otherwise legally authorized to render the same professional services within this state may organize and become a shareholder or shareholders of a professional corporation for pecuniary profit under the provisions of Title 23B RCW for the purpose of rendering professional service. One or more of the legally authorized individuals shall be the incorporators of the professional corporation.RCW 18.100.050 · apps.leg.wa.gov · default.aspx?cite=18.100&full=true · read 9 October 2026
(5)(a) Notwithstanding any other provision of this chapter, health care professionals who are licensed or certified pursuant to chapters 18.06 , 18.225, 18.22, 18.25, 18.29, 18.34, 18.35, 18.36A, 18.50, 18.53, 18.55, 18.57, 18.59, 18.64, 18.71, 18.71A, 18.74, 18.79, 18.83, 18.89, 18.108, and 18.138 RCW may own stock in and render their individual professional services through one professional service corporation and are to be considered, for the purpose of forming a professional service corporation, as rendering the "same specific professional services" or "same professional services" or similar terms.RCW 18.100.050 · apps.leg.wa.gov · default.aspx?cite=18.100&full=true · read 9 October 2026
It is the intent of this chapter, and this chapter shall be so construed, that persons so licensed shall only be authorized by law to charge or receive compensation for professional services rendered if such services are actually rendered by the licensee and not otherwise: PROVIDED, HOWEVER, That it is not intended to prohibit two or more licensees who practice their profession as copartners to charge or collect compensation for any professional services by any member of the firm, or to prohibit a licensee who employs another licensee to charge or collect compensation for professional services rendered by the employee licensee.RCW 19.68.040 · app.leg.wa.gov · default.aspx?cite=19.68&full=true · read 9 October 2026
Shown only where the jurisdiction publishes a provision specific to chiropractic.
quoted8. Telehealth includes telemedicine and means the use of asynchronous or synchronous telecommunication technology by a chiropractor to provide chiropractic services to a patient at a different physical location than the chiropractor. “Telehealth” does not include the use, in isolation, of email, instant message, text messaging or fax.CH-3-19-20B · doh.wa.gov · CQAC-TelehealthPolicy.pdf · read 9 October 2026
Generally, practitioners providing chiropractic services via telehealth to patients located in Washington State must hold either a license or temporary practice permit issued by the commission, with limited exceptions.CH-3-19-20B · doh.wa.gov · CQAC-TelehealthPolicy.pdf · read 9 October 2026
The commission must treat chiropractic care delivered by a chiropractor through telehealth in an identical manner to the provision of comparable chiropractic care delivered by a chiropractor in person (Section 5 of ESSB 5481).CH-3-19-20B · doh.wa.gov · CQAC-TelehealthPolicy.pdf · read 9 October 2026
A chiropractor’s failure to conform to professional practice standards, including the standard of care as found in chapter 18.25 RCW and 246-808 WAC whether the chiropractic care is provided in-person or via telehealth, may subject the chiropractor to potential discipline by the commission.CH-3-19-20B · doh.wa.gov · CQAC-TelehealthPolicy.pdf · read 9 October 2026
The commission does not endorse or evaluate the suitability of specific equipment and technology used to provide telehealth services.CH-3-19-20B · doh.wa.gov · CQAC-TelehealthPolicy.pdf · read 9 October 2026
The jurisdiction is the authority on everything here. These pages quote what the statute, the rules and the board publish and the date we read them; they do not interpret it. Laws and rules change. Confirm anything you intend to act on with the board.