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Arizona State Board of Massage Therapy
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    • DeRoest, S. Bailey, Public Member
    • Vacant., Public Member
    • Mhoon, Myriah, Public Member
    • Reiter, Angela M, LMT
    • Tapscott, Michael K., LMT
    • Fiscal Year 2023 budget Submission
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Directory

Find a Massage Therapist, & View Disciplinary Actions

To check application status, click Application Status Search Tool...

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Forms

Forms

Criminal Reporting, Change of Address, Name Change, Verification, ...

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File a Complaint

Complaint Form

Please use the Board's online link to submit your written...

File a Complaint

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:

NAME CHANGE FORM - Download PDF

NAME CHANGE FORM - Online

 

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.

DUPLICATE LICENSE FORM - Download PDF

DUPLICATE LICENSE - Online

Duplicate License Payment-  $25.00

$25.00 MONEY ORDERS / CASHIERS CHECKS ARE ACCEPTED

You can mail everything to:

Arizona Board of Massage Therapy

1740 W Adams St, Unit 3401

Phoenix, AZ 85007

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Contact Us
Arizona State Board of Massage Therapy
1740 West Adams, Suite 3401
Phoenix, Arizona 85007
To contact Board staff,
email [email protected]
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