Arizona Administrative Code
Title 4 - PROFESSIONS AND OCCUPATIONS
Chapter 15 - Board of Massage Therapy
Article 2 - LICENSING
Section R4-15-205 - Application for Renewal of a License

Universal Citation: AZ Admin Code R 4-15-205

Current through Register Vol. 30, No. 38, September 20, 2024

An applicant for a renewal license shall submit:

1. An application form that contains the licensee's:

a. Name;

b. Massage therapy license number;

c. Massage therapy license expiration date;

d. Birthdate;

e. Residence and practice addresses;

f. Residence and practice telephone numbers;

g. Mailing address;

h. E-mail address;

i. Alien status declaration if the licensee is not a citizen or national of the United States;

j. Declaration of whether the licensee has been charged with or convicted of a felony or an offense involving moral turpitude or prostitution, solicitation, or a related offense or entered into a plea of no contest during the two-year period immediately preceding the renewal application date and, if so the licensee shall provide the following information:
i. The charged felony or offense;

ii. The date of conviction;

iii. The court having jurisdiction over the felony or offense;

iv. The probation officer's name, address, and telephone number, if applicable;

v. A copy of the notice of expungement, if applicable; and

vi. A copy of the restoration of civil rights, if applicable;

k. Declaration that the licensee has completed the continuing education required by A.R.S. § 32-4225(E) during the two-year period immediately preceding the renewal application date or if audited, the documentation required in R4-15-303(B); and

l. Signature and date of submission; and

2. The fee required in R4-15-102(A).

Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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