Practice Visit Program
A modernized, more supportive Practice Visit Program is now being rolled out to regulated chiropractors across Alberta. It is designed to strengthen practice quality, support professional confidence and reinforce public trust. Every chiropractor member of Council and the Competence Committee has completed an in-clinic practice visit—ensuring leadership experienced the process first.
Next, registrants with formal discipline in the last 10 years, those who did not pass their last practice visits and registrants with five years or less of practice will be scheduled. If you are part of these groups, you will be provided with the assessment rubric and notice of your in-clinic visit in advance.
“I found the ‘in practice visit’ experience to be much more comprehensive than my previous ‘practice review’ experience. I welcomed the opportunity to discuss reasoning behind certain direction and found the in-person communication to be much more valuable to my practice.” ~ Chiropractor participant
Program improvements
The updated Practice Visit Program offers the following improvements:
- Assesses compliance with a broad enough range of standards
- Leads to lasting improvements in practice
- Provides meaningful, actionable feedback
- Maintains consistent assessment standards
- Connects timing of reviews to risk and performance
- Offers support to help professionals improve
The updated program is designed to be supportive, fair and helpful. One chiropractor participant reported the following:
“The new in-person practice visit process overall was informative and educational. It felt productive and focused on improvement in practice. It was nice to talk to the assessors and work through the rubric in real time. It was easier to understand deficiencies than to receive a letter after the fact. Upon receiving the letter, it was not a surprise what changes would help my practice to reflect the current standards and how to maintain them.” ~ Chiropractor participant
CCOA remains committed to a process that strengthens practice and supports chiropractors.
Background
The Practice Visit Program updates come directly from a key strategic initiative as part of the CCOA Council’s 2022–2027 Strategic Plan. Just as importantly, the updates were shaped by the extensive feedback chiropractors provided in the 2024 profession-wide survey. Registrants told CCOA they wanted broader assessment of standards, more actionable feedback, regular in-person review and a system that supports improvement rather than simply measuring it.
Program updates
At its November 2025 meeting, Council approved the following updates to the practice visit program:
- Frequency and method of review determined by performance and risk
- Assessment of broad compliance with standards and rules
- A shift from “recommended improvement” to mandated improvement, where needed
- Randomized and/or assessor-selected file reviews
- Active monitoring for compliance
- At least one in-person review for every professional during their career
The following registrants will be contacted to schedule a practice visit in the near future:
- Registrants with formal discipline in the past 10 years
- Registrants who did not pass their last practice visit
- Registrants in their first five years of practice
Newly registered professionals will receive an early in-clinic visit to help them feel confident and well-supported in practice.
If a visit goes well, the next review may be many years away and may be electronic rather than in person. If major areas for improvement are identified, the next visit may be sooner and may need to be in person again. This is right-touch regulation in action: focusing resources where they are needed and not where they aren’t.
Note: For many registrants, it may be years before your next scheduled visit.
Scheduling process
CCOA will reach out directly when it is time for your visit. You will:
- receive advance notice before your in-clinic review
- receive the full assessment rubric ahead of time
CCOA is committed to making this a constructive experience that strengthens practice, enhances public trust and supports every registrant throughout their career.
Self-submission process
Note: The following information reflects the self-submission process and will be updated as the revised Practice Visit Program rolls out in 2026.
When and how to complete your self-submission
At a minimum, your practice visit (self-submission practice review) will occur every three to five years. Regulated chiropractors who have been with CCOA one year or less must complete their self-submission before the end of their first year of registration. If you are required to complete another type of practice visit, you will be provided written notice from CCOA and the necessary documents.
What are the contents of a self-submission?
You will need to provide the following information in your self-submission:
- Member information and Clinic Overview
- Declaration
- Clinic layout
- Clinic photographs
- Diagnostic equipment
- Clinic stationary
- Accounting & Billing
- Financial documents
- Treatment record abbreviations
- Patient files (record-keeping competency)
- The primary focus of the review is your record-keeping. The Competency Committee, via a Clinical Advisor, will offer the most feedback on this section of your self-submission.
- While you are gathering your patient files, use the CCOA Record-Keeping Requirements Guide (found in the Resources section below) as a reference. The guide specifies exactly what the clinical advisor is looking for when reviewing your records.
How the CCOA Record-keeping Requirements Guide helps you meet practice standards
The CCOA Record-keeping Requirements Guide identifies what the minimally acceptable levels of performance are required of regulated chiropractors. It also specifies how the Competence Committee reviews your submission and identifies areas of improvement which are provided in your results letter. It is recommended that you use the guide before and after your practice review. It is also a great reference tool for achieving record-keeping standards on a daily basis.
How to apply the guide in your practice:
- Read the guide.
- Compare your clinical practice and decision-making against the direction in the guide.
- Scrutinize your clinical records against the guide.
- Make any changes necessary to address deficiencies that are observed.
What types of practice reviews does CCOA conduct?
Standard Practice Visit
Standard practice visits are conducted primarily through a self-submission practice review process. The self-submission process was developed by CCOA to ensure minimum standards of practice and support quality assurance in our profession. The primary focus of this review is professional, quality record-keeping.
Remedial Practice Visit
If regulated chiropractors are unsuccessful in their standard practice visit, a remedial practice visit will be carried out as soon as reasonably possible at the request of the Competence Committee or as the result of a discipline order. Supplemental practice visits are conducted primarily through a self-submission process.
Second Practice Visit (follows all remedial practice visits)
If a regulated chiropractor successfully completes their remedial practice visit, then a second practice visit is conducted primarily through a self-submission process. Second practice visits are conducted primarily through a self-submission process.
Remedial Practice Visit with Coaching
If a regulated chiropractor fails a remedial practice visit, they will have a second remedial practice review, with the addition of direct communication with the Competence Committee and any delegate of that committee. The regulated chiropractor must submit a remedial practice review with a self assessment of their record-keeping practices and their steps to correct deficiencies in their practice.
On-Site Practice Visit
An unsuccessful remedial practice visit with coaching will result in an on-site practice visit. The regulated chiropractor will be required to submit a self-assessment of their record keeping practices and their steps to correct deficiencies. This self-assessment will be discussed and audited at the onsite practice visit. The on-site peer practice visit will consist of a member of the Competence Committee, or someone appointed by them to attend in person the clinic of the regulated chiropractor. The peer reviewer will observe the clinic, interview staff and audit the self-assessment submitted.
Alternate assessment of the Requirement for Practice Review
Regulated CCOA chiropractors who are solely practicing in another regulated jurisdiction(s) must provide CCOA their most recent peer assessment results from their other regulated jurisdiction(s). Regulated members who practice primarily in other jurisdictions are required to provide other CCOA self-submissions or documentation as determined by the Competence Committee or Registrar.
Practice Review results reporting
- The self-submission practice review outcomes (see table below).
- Any follow-up competence activity required by the regulated chiropractor.
- If information obtained from the practice visit has been referred to the Complaints Director.
- Direct a regulated chiropractor to complete specific continuing competence requirements within a specified time; or
- Direct a regulated chiropractor to complete any examinations, testing, assessment, education or counselling considered by the Competence Committee to be advisable; or
- Direct a regulated chiropractor to practice under the supervision of another regulated chiropractor; or prohibit a regulated chiropractor from supervising other regulated chiropractors or students providing professional services.
What should you do once you receive your results?
The results letter serves two purposes:
- To provide the required reporting to you of what was observed relative to the Standards of Practice as interpreted by the CCOA Record-Keeping Requirements Guide.
- Recommendations made by the Clinical Advisor in the comments section that you need to use to improve your record-keeping combined with using the guide to make changes in your practice
How to understand your results
| Satisfactory results | ||
| Reported | Interpretation | Action required by the Regulated Chiropractor |
| Met Requirements | The practice visit results letter demonstrated appropriate record keeping, clinical decision-making in applying the Standards of Practice. | Seek out self-directed professional development that continues to lead to mastery in clinical practice and record-keeping. |
| Met Requirements with Comments | The practice visit results letter demonstrated appropriate record-keeping and clinical decision-making in applying the Standards of Practice.
The Competence Committee identified practices that require attention to continue to progress in your clinical competency. |
Evaluate the comments and adapt your record keeping and clinical practice based on the comments provided. |
| Met Requirements with Concerns | The practice visit results letter identified that you barely met the minimal standard of practice. There are concerns in your practice identified by the Competence Committee that should be addressed in your record-keeping or clinical decision-making in applying Standards of Practice. | Evaluate your clinical records and incorporate the changes recommended by the Competency Committee.
Seek out self-directed professional development that builds clinical decision making relative to the Standards of Practice in practice areas of concern identified by the Competence Committee. |
| Unsatisfactory results | ||
| Reported | Interpretation | Action required by the Regulated Chiropractor |
| Did Not Meet Requirements | The practice visit results letter identified practice activity that the Competency Committee has determined does not meet requirements for record-keeping or clinical decision-making in applying the Standards of Practice. | Immediate change in the deficiencies identified by the Competence Committee must be made.
After you read your results letter, you should determine the changes that are needed, including, but not limited to the following actions: Change your record-keeping by incorporating the changes recommended by the Clinical Advisor. Evaluate your competency relative to activities identified in the results letter to determine which continuing competence courses you need to meet the Standards. |
Resources and documents
- CCOA Record-Keeping Requirements Guide
- Successful Charting (a series of articles):
- Writing the Working Diagnosis
- SOAP Notes
- The Written Treatment Plan
- The Physical Exam
- CCOA Record-keeping Course