Name Change Online

Pursuant to A.R.S. § 32-4225(C), "Each licensee is responsible for reporting to the Board a name change and changes in business and home address and phone numbers within ten (10) after any change" (emphasis added). Please use the "Name Change Form" link to complete and submit your name change and supporting documentation:

Please use the "Duplicate License Form" link to request a new wall certificate or a wallet license due to a name change, or if you are requesting multiple wall certificates for multiple offices or to replace a lost or misplaced license.

Mandatory Criminal Reporting PDF

Pursuant to A.R.S. § 32-3208, a massage therapist or an applicant for licensure as a therapist, who has been charged with a misdemeanor involving conduct that may affect patient safety or a felony must notify the Arizona State Board of Massage, in writing, within ten (10) working days after the charge is filed.

Please use the "Mandatory Criminal Reporting form" to submit your misdemeanor or felony:

Complete with a pen and mail to the Board.

Mandatory Criminal Reporting - Online

Pursuant to A.R.S. § 32-3208, a massage therapist or an applicant for licensure as a therapist, who has been charged with a misdemeanor involving conduct that may affect patient safety or a felony must notify the Arizona State Board of Massage, in writing, within ten (10) working days after the charge is filed.

Please use the "Mandatory Criminal Reporting form" to submit your misdemeanor or felony:

Change of Address - Online

Pursuant to A.R.S. § 32-4225(C), "Each licensee is responsible for reporting to the Board a name change and changes in business and home address and phone numbers within ten (10) after any change" (emphasis added). Please use the "Address Change Form" link to complete and submit your change of address:

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