What the statutes mean

An individual does not have an automatic right to obtain a license to practice chiropractic. It is a privilege extended by the state that is conditioned on an individual achieving a certain level of academic success, passing required tests and, having obtained a license, following the statutes and rules that govern their professional and personal conduct. Since the license to practice chiropractic is a privilege, the license can be withdrawn by the state if a chiropractor violates the statutes or rules that control the profession.

The most important standard of conduct is the duty to properly evaluate a patient's condition and to inform the patient properly because these are the primary elements of the professional relationship between a chiropractor and his or her patients. The requirements of this rule are specific:

• A chiropractor must evaluate each patient to determine whether the patient presents a condition that is treatable under the chiropractic scope of practice. The evaluation must be based upon an examination appropriate to the presenting patient. In conducting the evaluation, you must utilize chiropractic science as described in s. Chir 4.02 and the principles of education and training of the chiropractic profession.
• If your assessment indicates a condition treatable by chiropractic, you must treat the patient using only the techniques and services allowed under the chiropractic scope of practice.
• If an evaluation indicates a condition which is not treatable through chiropractic, you must inform the patient that the condition is not treatable through chiropractic means and recommend that the patient seek additional advice or care.
• You may render concurrent or supportive chiropractic care to a patient, but you must refrain from further chiropractic treatment when a reasonable chiropractor would be aware that the patient's condition will not be responsive to further treatment.

There are a substantial number of additional rules that govern the conduct of a chiropractor. Many of the rules go beyond the clinical practice of chiropractic and control elements of a chiropractor's business dealings as well as their personal conduct. While it may seem that the state should only focus their attention on the clinical aspects of a practice, the state has an inherent obligation to protect the public. If a chiropractor runs his or her business and/or personal affairs in a manner that is viewed as a risk to the health or safety of the public, the state has the power to discipline the doctor or withdraw their license to practice.

Unfortunately, it is not possible to list all of the different circumstances under which an individual could violate one of these rules. The following is a table that describes the major rules with practical examples.

Clinical Conduct
Practical	Examples/Explanations
Practicing or attempting to practice when unable to do so with reasonable skill and safety to patients.	A chiropractor who receives anecdotal information about a new technique should not use the technique on a patient until proficiency has been achieved through education and training. A chiropractor who has a significant mechanical problem with an adjusting table or other equipment should not use the table or equipment until it has been properly repaired. When encountering a condition outside one's knowledge or experience, a chiropractor should not adjust the patient until they are confident that they have a thorough understanding of the patient's condition and, they have determined the condition to be treatable through chiropractic means.
Practicing or attempting to practice beyond the scope of a license issued by the board, including but not limited to acts prohibited under s. Chir 4.05 (1).	Chiropractors may not adjust animals even if requested to do so by the animal's owner unless they are under the direct, on premise, supervision of a licensed veterinarian. A chiropractor's scope of practice is strictly limited. If a chiropractor questions whether something is inside or outside their scope of practice they should not rely on advice given to them by another chiropractor. They should obtain a written opinion from the chiropractic examining board. Chiropractors in other states are allowed to do things that are not allowed under the chiropractic scope of practice in Wisconsin. For example, even though a chiropractor may have been properly trained in the use of acupuncture in Minnesota, they may not use acupuncture as part of their chiropractic practice in Wisconsin.
Performing professional services inconsistent with training, education or experience.	The state requires chiropractors who wish to manipulate a patient while under anesthesia to have successfully completed a specialized training course before practicing this procedure. The state requires chiropractors that use physiological therapeutics as part of their practices to have successfully completed a 48 hour specialized course on these modalities.
Practicing in a manner which substantially departs from the standard of care ordinarily exercised by a chiropractor.	This particular standard of conduct can be troublesome because of the lack of defined standards of care for the chiropractic profession. The examining board could use this standard of conduct to discipline a chiropractor whose style of practice significantly deviates from the norm. Areas of concern might involved: The standard attire of doctors or patients during treatment. The setting utilized by a chiropractor for treatment. X-ray, examination, or treatment protocols used by a doctor. Communication practices utilized by a doctor or a member of the doctor's staff.
Engaging in any practice which constitutes a substantial danger to the health, welfare or safety of a patient or the public.	This standard can be applied when a chiropractor engages in an activity that has not previously been ruled on by the board. Substantial danger to the health of the public may include: Adopting new clinical approaches for the history, examination, diagnosis or assessment of a patient before these approaches have been taught at a chiropractic college. The methods used by a chiropractor or his or her staff to interface with their patients. This might include the communication methods used by doctors or staff, the privacy afforded patients preparing for treatment, or the privacy of the treatment itself. The utilization of specific diagnostic procedures or adjusting techniques before they have been taught at a chiropractic college or been recognized as reliable by the chiropractic community. The public's safety might also be at risk based on the equipment or facilities utilized by a chiropractor for the treatment of a patient.
Failing to conduct a competent assessment, evaluation or diagnosis as a basis for treatment or consultation.	The examining board does not have a standard of practice upon which to base its decisions. It relies on chiropractors from the state, chosen for their expertise, to advise them as to whether or not a chiropractor has acted in a competent manner. It is especially important for chiropractors with cash patients to remember that the method of payment is not material to the chiropractor's responsibility to properly assess, evaluate, and diagnose the patient's condition. The basis for discipline under this standard of conduct is likely to be based on a review of the chiropractor's clinical documentation.
Engaging in excessive evaluation or treatment of a patient.	A complaint of this type will generally come from patients who feel that care went on well past the point of maximum chiropractic improvement or, from insurance companies that are dissatisfied with the quality of clinical documentation. Since published practice guidelines focus on treatment for uncomplicated cases, it is extremely important that chiropractors document the severity of the condition(s) they are treating. This documentation can substantiate the need for more frequent exams or extended treatment for patients with multiple or severe problems.
Knowlingly falsifying patient records.	All information entered into a patient's record must be, to the best of the chiropractor's knowledge, factually based. A chiropractor may never knowingly enter information into a patient's clinical record that is not factually based to obtain insurance reimbursement or to justify his or her evaluation, assessment, diagnosis or treatment of the patient. Chiropractors must accurately record all of the services provided to the patient regardless if the patient or a third party paid for the services. It is not a violation of the law to properly revise the patient's file or supplement the records with additional factual information. For example, if clinical or diagnostic information was overlooked or misplaced, it should be entered into the patient's record whenever it is discovered, even if records have already been sent to an insurance company.
Aiding or abetting or permitting unlicensed persons in the practice of chiropractic.	A chiropractic may not: allow a student who has taken their licensure exam but has not yet received the results to treat a patient. allow a chiropractic assistant to perform services for which he or she has not been properly trained (see delegation rules). allow a chiropractic assistant to perform services that are not allowed to be delegated to a chiropractic assistant (see delegation rules). This includes: examining a patient (except for preliminary components allowed under the delegation rules). assessing the condition of a patient. diagnosing the patient's condition. recommending or preparing the patient's treatment plan. treating the patient except for those services specifically authorized by the delegation rules. independently preparing the patient's clinical documentation (note: there is nothing wrong with a CA acting as a note taker for the doctor.)
Personal Conduct
Prohibited Practices	Practical Examples/Explanations
Engaging in sexual contact, exposure, gratification, or other sexual behavior with or in the presence of a patient.	Chiropractors, as part of the manner in which they practice, touch patients more frequently and more intimately than many other health care providers. Because some patients may not be aware of the adjusting techniques used by chiropractors, chiropractors should consider having a CA in the treatment room if a patient is at all hesitant about the exam or adjusting process. There is an increased risk for violating this standard of conduct for chiropractors that: attempt to have a personal relationship with a patient outside the office. engage in "off color" joke telling. make personal comments about a patient's appearance or attractiveness. touch a patient in any unprofessional manner. request that a patient remove clothing when it is not necessary for their evaluation or treatment. solicit personal information from the patient that is not necessary to evaluate their past health or their current condition.
Practicing or attempting to practice while the ability to perform is impaired by physical, mental or emotional disorder, drugs or alcohol.	If a chiropractor has consumed any amount of alcohol or a recreational drug, they should strongly consider refraining from any patient interaction until the alcohol or drug has left their system. This "zero tolerance" guideline is much stricter than is required by this rule; however, chiropractors want to avoid the devastating consequences to their reputation of practicing while impaired by alcohol or drugs. If a chiropractor suffers from a serious illness or sustains an injury that impairs their ability to practice, they must arrange for their patients to see another chiropractor until they have sufficiently recovered and are able to resume their practice.
Impersonating another chiropractor.	Chiropractors are required to report their work under their own identifying numbers. If a doctor has filed the proper corporation documents, they may bill for services utilizing the identification number of their service corporation. A chiropractor may never prepare clinical documentation under another doctor's name. When chiropractors provide vacation or illness relief, they must produce clinical documentation under their own name.
Refusing to render services to a person because of race, color, sex or religion.	There are separate state statutes (see AIDS) that prohibit discrimination against patients with AIDS. While a chiropractor may prefer to see male or female patients, they may not discourage patients or restrict their practice to a single gender. Staff members should be advised never to ask an individual wishing to schedule an appointment for their race, color, sex or religion.
Business Conduct
Practical	Examples/Explanations
Revealing confidential patient information without consent of a patient, except that information shall be revealed to the board or its representatives pursuant to investigation of a licensee or as otherwise allowed by law.	The confidentiality of a patient is frequently violated because of the propensity of chiropractors and their staffs to discuss the names of current and past patients. While a patient is always allowed to discuss any aspect of their care, including the name of their treating chiropractor, a chiropractor or their staff is never allowed to reveal the name of a patient without the patient's permission. This standard of conduct does not apply when a chiropractor has a patient sign a waiver that allows patient identifying information to be revealed to an insurer or other party attempting to get payment for their care. The privacy rights are also protected by other state and federal statutes (please see index).
Obtaining or attempting to obtain any compensation for chiropractic services by fraud.	Chiropractors must collect the deductibles and co-payments required by patient's insurance company. The use of "no out-of-pocket expense" payment arrangements may constitute insurance fraud, and may violate this standard of conduct as well as s.943.395, Stats. Patients who pay out of pocket for their services may request a billing that can be submitted to their insurance company for reimbursement. The amount shown on the bill must equal the amount actually paid by the patient. An amount shown on the bill greater than the amount paid by the patient would constitute insurance fraud. A patient may not be billed for services they did not receive. This includes: billing for evaluation management services at a level higher than actually performed. billing for CMT services at a level higher than actually performed. billing for physical therapy services in units higher than were actually performed or for services that were not performed. billing an inaccurate CPT code in order to receive greater reimbursement than is actually due.
Failing to exercise a reasonable degree of supervision over subordinate employees.	The chiropractor must always be on the premises when work is delegated to a staff person. For example, a staff person may not take x-rays or do any form of physical therapy on a patient when the doctor is at lunch or out of the office for any reason. Regardless of how busy the practice, a chiropractor is always responsible for the actions of a staff member. Staff members are not allowed to perform any clinical service unless it is allowed under the delegation rules. Even though staff members have received the required x-ray or PT training, a chiropractor is still responsible for all of their work.
Obtaining or attempting to obtain a license through fraud or misrepresentation.	Current license holders would be affected by this standard of conduct if they attempted to renew their license without having obtained the required number of continuing education hours required by the examining board.
Failing to maintain patient records for a minimum period of 7 years after the last treatment or after the patient reaches the age of maturity, whichever is greater.	This standard of conduct refers to the clinical records of a patient including the patient's x-rays, the results of any diagnostic tests and, records obtained from other health care providers. All must be kept for 7 years from the date of the last patient office visit. The records of children must be kept for 7 years or until the child reaches the age of 18. For example, you would need to keep the clinical records of a child who received their last chiropractic treatment at the age of 7 until the child reached the age of 18. You would need to keep the records of a minor who received their last chiropractic treatment at the of 17 for 7 years. This standard applies only to the clinical documentation of a chiropractor. Insurance EOB's and administrative information may be destroyed as soon as it is no longer useful to you. Remember to save the information required by the Internal Revenue Service for your tax returns.
Failing to release patient health care records to a patient in accordance with s. 146.83, Stats.	A patient is entitled to a copy of their records whenever they request them. It would be a violation of this standard of conduct to withhold a patient's records because they refused to pay for their records or had an unpaid balance. It would be a violation of this standard of conduct to withhold a patient's records when requested by another health care provider. (See the next point) Original records or x-rays should never be given to a patient or other health care provider. Not only does the chiropractor expose themselves to malpractice risks if the records are not returned, the chiropractor violates the standard requiring records to be kept on each patient for 7 years. Patients or other health care providers should always receive a copy of the patient's x-rays or records.
Negating the co-payment or deductible provisions of a contract of insurance by agreeing to forgive any or all of the patient's obligation for payment under the contract unless the chiropractor reduces the chiropractor's claim to the insurance carrier in regard to that patient by an equal proportion. In this section, "co-payment or deductible provisions" means any terms in a contract of insurance with a third party whereby the patient remains financially obligated to the chiropractor for payment.	Under this standard of conduct a chiropractor may not waive the patient's co-payment or deductible even if the chiropractor is trying to remain competitive with a managed care company. It is not a violation of this rule for a chiropractor to adjust fees, but the fee charged must be accurately reported to any third party payor. It is not a violation of this rule for a chiropractor to provide treatment without charge. Chiropractors are not responsible if they bill for the patient's co-payment or deductible and the patient cannot pay for reasons of financial hardship and the hardship is documented in the doctor's records. If no documentation exists, the reasonableness of the chiropractor's position might be the number of times co-pays or deductibles were waived compared to the number of patient's seen by the doctor and the type of attempts made to collect past due amounts.
Advertising
Practical	Examples/Explanations
Advertising is a manner which is false, deceptive or misleading. An advertisement which does any of the following is false, deceptive or misleading: Contains a misrepresentation of fact. Is likely to mislead or deceive because of a failure to disclose material facts. Is intended to or is likely to create false or uninjured expectations of favorable results. Fails to prominently disclose complete details of all variables and material factors relating to any advertised fee. Contains any representations or implication that in reasonable probability will cause an ordinarily prudent person to misunderstand or be deceived. Includes reference to or implies specialization or advanced training unless all of the following are true: The specialty is recognized by a council of the American Chiropractic Association or the International Chiropractors Association. The specialty requires at least 300 hours of postgraduate credit hours and passage of a written examination approved by the American Chiropractic Association or the International Chiropractors Association. The title applied to the specialty by the chiropractor is the title applied by the American Chiropractic Association or the International Chiropractors Association. Includes reference to or implies advanced training unless all of the following are true: The postgraduate training was received in one, unified program approved by the American Chiropractic Association or the International Chiropractors Association, or through one, unified program at a college accredited by the Council on Chiropractic Education and approved by the board. The chiropractor has completed at least 100 hours of postgraduate training in the area in which the chiropractor claims advanced training. The postgraduate training program includes successful completion of a written examination as a requirement for successful completion of the training program. Appears in any classified directory, listing or other compendium under a heading, which when considered together with the advertisement, has the capacity or tendency to be deceptive or misleading with regard to the profession or professional status of the chiropractor. Implies that the chiropractic services provided will result in emotional or spiritual benefits.	Advertising is a very difficult area for the examining board to enforce because antitrust laws and the first amendment protect some types of advertising that these standards of conduct appear to ban. If a chiropractor wants to use an aggressive approach to advertising, they would be well advised to send an advance copy of the advertising to the examining board's legal counsel for review. If the board finds the advertising objectionable, the doctor should consider having his or her legal counsel discuss the matter with the board prior to running the ad. If a chiropractor chooses to advertise that a patient may receive a group of services for a fixed price, it is very important that they list every service that will be received by the patient. For example, if a chiropractor advertises "free" services he or she must list each service that the patient will receive for "free". Advertising may never be used to guarantee or imply that a patient will favorably respond to a doctor's care. A chiropractor may not use their advertising to imply that they have advanced training or education in any subject unless they have successfully completed at least 100 hours of postgraduate education in a specialty recognized by a council of the ACA or ICA. For example, a chiropractor that obtains a 48-hour CCSP certificate may not advertise their CCSP credential. A doctor successfully completing the test for the 100 hour CCSP program is allowed to advertise their credential. HCFA places limits on ads directed to Medicare patients. For a current list of restrictions, please contact the Medicare carrier. When yellow pages or other advertising is grouped according to specialty or subject, a chiropractor may only advertise their services under classifications that directly relate to the chiropractic profession. For example, it would be a violation of this standard of conduct for a chiropractor to advertise their services under a "physical therapy" or "medical" classification. While the care of a chiropractor may result in an improvement in a patient's emotional or spiritual well being, a chiropractor may never, under any circumstances, advertise this as a benefit of chiropractic care. If a chiropractor chooses to use patient testimonials in their advertising, they should have a signed statement from the patient attesting that their statement was made voluntarily and a list of ads in which the testimonial may appear. These advertising standards of conduct apply to all forms of advertising including marketing done through brochures, seminars and videos.
Examining Board
Practical	Examples/Explanations
Refusing upon the request to cooperate in a timely manner with the board's investigation of a complaint lodged against a license.	If a chiropractor takes longer than 30 days to respond to a request from the examining board, they have the burden of demonstrating that they have acted in a timely manner. Chiropractors have the right to ask that an attorney respond to the examining board on their behalf.
Knowingly providing false information to the board or its representatives.	The board has the authority and sufficient resources to fully investigate a complaint. It is better for a chiropractor to hire an attorney to represent them before the board than to provide false information to the board.
Failing to notify the board of having a chiropractic license, certificate, permit or registration granted by any other jurisdiction subject to disciplinary action.	The Wisconsin Department of Regulation & Licensing now belongs to a nationwide system that links licensing boards from around the country. While there may be a delay in updating the data base, or for the department to audit data from other states, it is only a matter of time before the department finds out about a disciplinary action that occurred in another state.
Failing to notify the board of any criminal conviction, the circumstances of which relate substantially to the practice of chiropractic.	Since the board is likely to find out about a criminal conviction from another source, a chiropractor only compounds their situation by withholding this information from the board. Since an individual is innocent until proven guilty, there is no requirement to report to the board until a conviction has occurred.
Criminal or Civil Acts
Practical	Examples/Explanations
Being convicted of a crime substantially related to the practice of chiropractic.	In the ever evolving field of health care, there are a plethora of laws dealing with chiropractic that are not listed in the statutes or rules governing the chiropractic profession. This standard of conduct covers the examining board in the event that they want to take action against a chiropractor that has been convicted of a crime not specifically mentioned in the rules.
Violating a law, or aiding or abetting the violation of any law substantially related to the practice of chiropractic.	This is substantially the same as the previous item except that the examining board may decide that a chiropractor may be disciplined if they knowingly helped someone violate the law even if they were not convicted. An example might be a chiropractor that knows his or her associate makes up a diagnosis for a patient without actually examining the patient and does not take action to stop the practice.
Violating any provision of ch. 446, Stats., or any rule or order of the board.	This standard essentially duplicates the previous two listings.
Having a license, certificate, permit or registration granted by another jurisdiction to practice as a chiropractor limited, suspended or revoked, or subject to any other disciplinary action.	This standard essentially duplicates a previously listed standard of conduct.

A violation of these rules does not mean that a chiropractor will automatically lose their license to practice. If a complaint is brought against a chiropractor, the Department of Regulation and Licensing will institute an investigation. At the conclusion of the investigation, the department's personnel will determine if they have sufficient evidence to warrant disciplinary action against the chiropractor. If they believe the actions of the chiropractor warrant disciplinary action, the chiropractor will have a full and complete opportunity to defend themselves. (Please see full description of the complaint process described in RL 2.) Even if discipline is warranted, the state has a full range of penalties available that do not include the suspension or revocation of a license to practice. Licenses are suspended or revoked only where the conduct has been particularly egregious.

The penalties imposed by the insurance industry or the public can have a far greater impact than those imposed by the state. The imposition of any discipline is likely to be publicized by local newspapers, TV or radio. This negative publicity, even for a relatively minor offense, can have an impact on the growth of a practice for years.

If the chiropractor has managed care agreements, there can be very severe financial consequences, even for minor rule transgressions. Most managed care agreements require a doctor that has been disciplined by the licensing board to notify them within a short period of time. The managed care company then has the right to terminate the managed care agreement based on the disciplinary action taken by the examining board. Since managed care companies are very sensitive about their public image, it would not be unusual for them to replace a chiropractor who has been disciplined with one who has a clear record.

Statute excerpts

Chir 6.01 Authority.

The rules in ch. Chir 6 are adopted under authority in ss. 15.08 (5) (b), 227.11 and 446.04, Stats.

Chir 6.015 Definition.

In this chapter:

1. "Advertisement" means any communication disseminated or intended to be disseminated to the public which is likely to or intended to induce, directly or indirectly, the rendering of professional services by the chiropractor named in or identified by the communication. "Advertisement" includes professional business cards, professional announcement cards, office signs, letterhead, telephone directory listings, directories or listings of health care practitioners, and communications which are likely to or intended to induce, directly or indirectly, the rendering of professional services by the chiropractor named in or identified by the communication in newspaper, broadsides, flyers, radio, television, books, magazines, or motion pictures.

Chir 6.02 Unprofessional conduct. Unprofessional conduct by a chiropractor includes:

1. Engaging in any practice which constitutes a substantial danger to the health, welfare or safety of a patient or the public.
2. Practicing or attempting to practice when unable to do so with reasonable skill and safety to patients.
3. Practicing in a manner which substantially departs from the standard of care ordinarily exercised by a chiropractor.
4. Practicing or attempting to practice beyond the scope of a license issued by the board, including but not limited to acts prohibited under s. Chir 4.05 (1).
5. Practicing or attempting to practice while the ability to perform is impaired by physical, mental or emotional disorders, drugs or alcohol.
6. Performing professional services inconsistent with training, education or experience.
7. Engaging in sexual contact, exposure, gratification, or other sexual behavior with or in the presence of a patient.
8. Engaging in excessive evaluation or treatment of a patient.
9. Failing to conduct a competent assessment, evaluation or diagnosis as a basis for treatment or consultation.
10. Revealing confidential patient information without consent of a patient, except that information shall be revealed to the board or its representatives pursuant to investigation of a licensee or as otherwise authorized by law.
11. Refusing to render services to a person because of race, color, sex or religion.
12. Knowingly falsifying patient records.
13. Impersonating another chiropractor.
14. Obtaining or attempting to obtain any compensation for chiropractic services by fraud. Note: The use by a licensee of "no out-of-pocket expense" payment arrangements may constitute insurance fraud, and may therefore violate this subsection as well as s. 643.395, Stats.
15. Advertising in a manner which is false, deceptive or misleading. An advertisement which does any of the following is false, deceptive or misleading:
1. Contains a misrepresentation of fact.
2. Is likely to mislead or deceive because of a failure to disclose material facts.
3. Is intended to or is likely to create false or uninjured expectations of favorable results.
4. Fails to prominently disclose complete details of all variables and material factors relating to any advertised fee.
5. Contains any representations or implication that in reasonable probability will cause an ordinarily prudent person to misunderstand or be deceived.
6. Includes reference to or implies specialization or advanced training unless all of the following are true:
1. The specialty is recognized by a council of the American Chiropractic Association or the International Chiropractors Association.
2. The specialty requires at least 300 hours of postgraduate credit hours and passage of a written examination approved by the American Chiropractic Association or the International Chiropractors Association.
3. The title applied to the specialty by the chiropractor is the title applied by the American Chiropractic Association or the International Chiropractors Association.
7. Includes reference to or implies advanced training unless all of the following are true:
1. The postgraduate training was received in one, unified program approved by the American Chiropractic Association or the International Chiropractors Association, or through one, unified program at a college accredited by the Council on Chiropractic Education and approved by the board.
2. The chiropractor has completed at least 100 hours of postgraduate training in the area in which the chiropractor claims advanced training.
3. The postgraduate training program includes successful completion of a written examination as a requirement for successful completion of the training program.
8. Appears in any classified directory, listing or other compendium under a heading, which when considered together with the advertisement, has the capacity or tendency to be deceptive or misleading with regard to the profession or professional status of the chiropractor.
9. Implies that the chiropractic services provided will result in emotional or spiritual benefits.
16. Aiding or abetting or permitting unlicensed persons in the practice of chiropractic.
17. Failing to exercise a reasonable degree of supervision over subordinate employees.
18. Obtaining or attempting to obtain a license through fraud or misrepresentation or making any material misstatement, omission or falsification in connection with an application for a license, registration, or renewal.
19. Refusing upon request to cooperate in a timely manner with the board's investigation of a complaint lodged against a license. Licensees taking longer than 30 days to respond shall have the burden of demonstrating that they have acted in a timely manner.
20. Knowingly providing false information to the board or its representative.
21. Failing to notify the board of having a chiropractic license, certificate, permit or registration granted by any other jurisdiction subject to disciplinary action.
22. Having a license, certificate, permit or registration granted by another jurisdiction to practice as a chiropractor limited, suspended or revoked, or subject to any other disciplinary action.
23. Failing to notify the board of any criminal conviction, the circumstances of which relate substantially to the practice of chiropractic.
24. Being convicted of a crime substantially related to the practice of chiropractic.
25. Violating any provision of ch. 446, Stats., or any rule or order of the board.
26. Violating a law, or aiding or abetting the violation of any law substantially related to the practice of chiropractic.
27. Failing to maintain patient records for a minimum period of 7 years after the last treatment or after the patient reaches the age of majority, whichever is greater.
28. Failing to release patient health care records to a patient in accordance with s. 146.83, Stats.
29. Negating the co-payment or deductible provisions of a contract of insurance by agreeing to forgive any or all of the patient's obligation for payment under the contract unless the chiropractor reduces the chiropractor's claim to the insurance carrier in regard to that patient by an equal proportion. In this section, "co-payment of deductible provisions" means any terms in a contract of insurance with a third party whereby the patient remains financially obligated to the chiropractor for payment. Note: It is no violation of this rule for a chiropractor to adjust fees, but the fee charged must be accurately reported to any third party payor. It is no violation of this rule for a chiropractor to provide treatment without any charge.
30. Giving or receiving unauthorized assistance, violating rules of conduct, or otherwise cheating or acting dishonestly respecting any examination required for the granting of a license or registration to practice chiropractic.

Duty to evaluate and inform

Chir 6.03 (1)

A chiropractor shall evaluate each patient to determine whether the patient presents a condition that is treatable through chiropractic means. An evaluation shall be based upon an examination appropriate to the presenting patient. In conducting an evaluation, a chiropractor shall utilize chiropractic science as described in s. Chir 4.02 and the principles of education and training of the chiropractic profession.

Chir 6.03 (2).

If an evaluation indicates a condition treatable by chiropractic means, the chiropractor shall treat the patient using appropriate chiropractic means.

Chir 6.03 (3).

If an evaluation indicates a condition which is not treatable through chiropractic means, the chiropractor shall inform the patient that the condition is not treatable through chiropractic means and recommend that the patient seek additional advice or care.

Chir 6.03 (4).

A chiropractor may render concurrent or supportive chiropractic care to a patient, but a chiropractor shall refrain from further chiropractic treatment when a reasonable chiropractor should be aware that the patient's condition will not be responsive to further treatment.