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Forms
Renewal License Application
RENEWAL PAYMENT ONLY - Online Payment
RENEWAL APPLICATION - Online Form
PLEASE NOTE: All fees are non-refundable, pursuant to A.A.C. R4-25-103.
Mandatory Criminal Reporting
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:
MANDATORY CRIMINAL REPORTING FORM - Download PDF
MANDATORY CRIMINAL REPORTING FORM - Online
Change of Address
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:
ONLINE ADDRESS CHANGE -
ADDRESS CHANGE - Online Form
Name Change and Replacement/Duplicate License Requests
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:
ONLINE NAME CHANGE FORM -
NAME CHANGE FORM - Online Form
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.
ONLINE DUPLICATE LICENSE -
After payment, you get Authorization Code # to place on Form.
DUPLICATE LICENSE PAYMENT ONLY - Online Payment
DUPLICATE LICENSE - Online Form
PLEASE NOTE: All fees are non-refundable, pursuant to A.A.C. R4-25-103.
State of Arizona Verification and Volunteer Health Services Registration
Please use the "Request Verification Form" to request verification of your Arizona license be sent to another jurisdiction/licensing board.
ONLINE REQUEST VERIFICATION -
REQUEST VERIFICATION - Online Form
VERIFICATION OF NON-AZ LICENSE - Download PDF
The pdf form below is strictly for volunteering your services, as a massage therapist, without collecting a fee. Only out-of-state massage therapists are eligible for this registration.
VOLUNTEER HEALTH SERVICES - Download PDF
