Chiropractic Society of Texas Membership Application
The Chiropractic Society of Texas is about empowering ChiropracTORS and preserving and protecting ChiropracTIC. Ours is not a profession in need of redefinition. Chiropractic is a gift given to us by Drs. D.D. and B.J. Palmer in the form of a congruent science, art, and philosophy. Any additions or deletions will only weaken it. All adjunctive therapies from nutritional to acupuncture are neither good nor bad. They simply are not ChiropacTIC. The CST does not choose to dictate how you practice. If your sole intent is the detection and correction of the vertebral subluxation so that Innate Intelligence may be expressed free of interference and that all those you touch experience and express Life at a higher level, we welcome you.

Annual Dues: $200.00
First Year D.C.: $50.00
Application Fee: $20.00
Students: Complimentary

First Name *
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Last Name *
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Office Address
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Office Phone Number
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Home Address *
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Primary Phone Number *
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Primary Email Address *
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Birthdate *
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Birthplace
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Chiropractic College & Graduation Date
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States Licensed to Practice Chiropractic
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License Number *
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Which best describes your practice
List special courses you have taken.
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List all instruments and special equipment used in your office.
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Memberships in organizations and clubs (Chiropractic and civic)
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Are there any malpractice suits pending against you?
Do you have an associate or an assistant practicing with you? If so, what are their names?
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I, the undersigned, do hereby agree to abide by the By-Laws and ethical code of this association, if accepted, and promise to give my time and efforts to promote the aims set forth in the Preamble. *
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