Applications and Forms

Initial/Reciprocal License Application Form and Instructions 

Grandfathering Application Form and Instructions 

Establishment License Application 

Sample Compliance Plan for Multiple Therapist Establishments 

All multiple therapist establishment applications must be accompanied by a compliance plan. The above sample may be used for guidance.

CORI Permission Form 

If you have been asked to provide the Board permission to request a CORI check, please submit this form.

Verification Request 

If you require a certificate of verification to go to another jurisdiction(s), please submit separate verification request forms with applicable fees for each verification requested.

Certification of Standing Request 

Online Address Change for Massage Therapists

The Online Change of Address feature allows you to change your address of record listed in our database. To use this function, you must provide certain information for authorization.

Change of Name or Request for Duplicate License for Board of Registration of Massage Therapy

This PDF form maybe used to request a name change, address change or a duplicate license.

Health Care Fraud Complaint Application 

Division of Professional Licensure Complaint Form