Level I of Certification Candidate Requirements

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  • September 26, 2014

Level I candidates will be tested on their ability to “take” accurate x-rays with excellent image quality. This image must be properly positioned and all structure identification must be clearly seen on all films.

An online exam is required. The standards of this level of certification are that the doctor has knowledge and applicable skills in the following areas:

  • Understanding of x-ray alignment procedures
  • Theory about distortion, magnification and collimation
  • Structural identification on x-ray
  • X-ray filtration
  • Proper x-ray technique and exposures, image quality
  • Patient adjusting steps and purpose of the individual steps
  • NUCCA Historical perspective
  • Use of NUCCA equipment for patient care
  • Leg check and Anatometer procedures
  • Neurological mechanisms of the cervical region
  • Patient positioning for cervical x-rays

A passing grade of 80% is necessary for the online exam.


  • Four views of alignment films. Format can be found in the NUCCA text book and past monographs. X-ray equipment must be aligned to NUCCA standards to participate in all three levels of certification.
  • Five pre-unanalyzed, consecutive sets of patient x-rays demonstrating necessary protocols for patient placement in all three views (Lateral, Nasium, Vertex).
  • Two consecutive sets of both pre and post x-rays, demonstrating necessary protocols for patient placement.

Critical points of consideration include proper exposures, the use of the appropriate filters, proper views of structures, (i.e. posterior arch on the nasal view), and minimal distortions (i.e. rotation and location of structure on the x-ray film).

Previously reviewed x-rays may not be resubmitted.

After the first set of five pre films have been approved an additional requirement of two consecutive sets of both pre and post x-rays need to be submitted. This set of pre and post films are used exclusively for the criteria of patient placement used in the first five sets of films. These are not evaluated for analysis or reduction of the subluxation.

Once a doctor has completed and passed the online exam, alignment films, five consecutive pre x-rays, two consecutive pre and post films, they are eligible as a candidate for the second level of the NUCCA Board Certification process.

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