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When seeking to become a licensed massage therapist in Texas, understanding the Massage License Texas Lookup form is essential. This form plays a crucial role in the application process for individuals who have held licenses in other states. It requires the applicant to provide personal details such as their name, address, and license number, along with a signature authorizing the release of their licensing information from previous states. The form is divided into two sections: the first is for the applicant to fill out, while the second must be completed by the licensing authority from the applicant's previous state. This second section verifies the status of the applicant’s out-of-state license, indicating whether it is active, lapsed, inactive, denied, suspended, or revoked. Additionally, it gathers information about the qualifications for licensure in that state, including education hours and examination requirements. Completing this form accurately is vital, as it ensures that all necessary information is available for the Texas Department of State Health Services to make an informed decision regarding the applicant’s licensure.

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MASSAGE THERAPY LICENSING PROGRAM

TEXAS DEPARTMENT OF STATE HEALTH SERVICES

P.O. Box 149347, Mail Code 1982

Austin, Texas 78714-9347

OUT OF STATE LICENSE VERIFICATION

The application for licensure as a Massage Therapist in the State of Texas requires this form to be completed by all State Boards where I hold or have ever held a license. My signature below is your authorization to release all information in your files, favorable or otherwise, regarding myself. Section I to be completed by applicant. Please type or print

clearly.

Applicant Name ___________________________________________ License Number __________________

Applicant’s Signature _______________________________________ Date ___________________________

Address __________________________________________________________________________________

P O Box or Street No. CityState Zip

Telephone Number (include area code) ______________________________ Date of Birth ________________

Section II. (Completed by out-of-state licensing authority)

State of ___________________________________________.

 

 

This certifies that ____________________________________ is:

 

 

 

(Applicant’s Name)

 

 

 

Registered [ ]

Certified [ ]

Licensed [ ] as a ___________________________________________

Current status of this license/license/certification is:

 

 

Active [ ]

Lapsed [ ]

Inactive [ ]

Denied ** [ ]

Suspended** [ ]

Revoked** [ ]

Effective date of License/Registration/Certification________________________________________________

**Please attach a copy of the Findings of Fact and Decision and Order. License/Registration/Certification issued based on:

[

]

Education Requirements

[

]

Endorsement/Reciprocity

[

]

State Examination

[

]

Grandfather Requirements

[

]

National Examination

 

 

 

Qualifications for licensure in this state are:

a.Total hours of education ________

b.Number of hours required in Swedish Massage ________

c.Number of hours required in Anatomy & physiology ________

d.

Written examination required? Yes [

]

No

[

]

e.

Practical examination required? Yes [

]

No

[

]

Please attach a copy of the current massage therapy requirements (rules) for your state. (If current rules have been sent to this office within the last 12 months, please disregard this request.)

I certify that the above information is correct and true. I have enclosed a copy of the requirements for this state. Name of Agency __________________________________ Address _________________________________

Signature ___________________________________ Typed Name __________________________

Title _______________________________________ Date ________________________________

(STATE SEAL)

DSHS Publication # F64-10701 Massage Therapy Application Revised 5/09

Form Specifications

Fact Name Details
Purpose This form is used for out-of-state license verification for applicants seeking a Massage Therapist license in Texas.
Authorization The applicant must sign the form to allow the release of all licensing information from previous states.
Governing Law The licensing process is governed by the Texas Occupations Code, Title 3, Chapter 455.
Requirements Applicants must provide details such as education hours and examination requirements from their home state.

Massage License Texas Lookup: Usage Guidelines

Filling out the Massage License Texas Lookup form is an important step for individuals seeking licensure as a Massage Therapist in Texas. This form requires information from both the applicant and the out-of-state licensing authority. Completing it accurately ensures that the necessary information is provided for a smooth verification process.

  1. Obtain the form: Ensure you have the correct Massage License Texas Lookup form from the Texas Department of State Health Services.
  2. Section I - Applicant Information: Fill out your name, license number, and date of birth clearly. Provide your current address and telephone number, ensuring all information is accurate.
  3. Signature: Sign and date the form in the designated area to authorize the release of your licensing information.
  4. Section II - Licensing Authority: This section must be completed by the out-of-state licensing authority. Make sure they fill in the state, your name, and the status of your license.
  5. Current License Status: The licensing authority will indicate whether your license is active, lapsed, inactive, denied, suspended, or revoked.
  6. License Details: The licensing authority should complete information about the effective date of your license and the basis for your licensure.
  7. Education and Examination Requirements: The authority will provide details about total hours of education, hours required in Swedish massage, and anatomy & physiology. They will also indicate if written and practical examinations are required.
  8. Attach Supporting Documents: Ensure the out-of-state licensing authority attaches a copy of the current massage therapy requirements for their state.
  9. Final Certification: The licensing authority must sign, print their name, and include their title and date. A state seal may also be required.

Once you have completed the form and gathered all necessary documentation, it can be submitted to the Texas Department of State Health Services for processing. Make sure to keep a copy of everything for your records.

Your Questions, Answered

What is the purpose of the Massage License Texas Lookup form?

The Massage License Texas Lookup form is used to verify the licensure status of individuals who are applying for a massage therapy license in Texas. This form must be completed by the licensing authority from any state where the applicant holds or has ever held a massage therapy license. It ensures that all relevant information regarding the applicant’s professional history is disclosed, helping to maintain the integrity of the licensing process in Texas.

Who needs to complete this form?

Any individual applying for a massage therapy license in Texas must complete this form. This includes applicants who have previously held a license in another state. The form requires the applicant to provide their personal information and authorize the release of their licensing records from other states to the Texas Department of State Health Services.

What information is required from the applicant on the form?

The applicant must provide their full name, license number, signature, date of birth, address, and telephone number. This information helps ensure that the Texas Department of State Health Services can accurately verify the applicant's licensing history. It is important that the applicant fills out this section clearly and completely to avoid any delays in processing their application.

What does Section II of the form entail?

Section II must be completed by the out-of-state licensing authority. This section certifies the applicant's status as a registered, certified, or licensed massage therapist. It also includes details about the current status of the applicant's license, such as whether it is active, lapsed, inactive, denied, suspended, or revoked. Additionally, it requires information about the qualifications for licensure in that state, including education hours and examination requirements.

What should be attached to the form when submitting it?

When submitting the form, the applicant must attach a copy of the current massage therapy requirements or rules from the state where they are licensed. If these rules have been sent to the Texas Department of State Health Services within the last 12 months, the applicant may disregard this request. Furthermore, if the applicant’s license is denied, suspended, or revoked, they must include a copy of the Findings of Fact and Decision and Order.

How can I ensure that my application is processed efficiently?

To ensure efficient processing of your application, complete all sections of the form accurately and clearly. Make sure to provide any required attachments, such as the current rules from your licensing state and any necessary documentation regarding the status of your license. Submitting a well-prepared application can help avoid delays and facilitate a smoother review process.

Common mistakes

  1. Failing to print clearly when filling out the form. Illegible handwriting can lead to misunderstandings and delays.

  2. Not providing a complete address. Ensure that your street address, city, state, and zip code are all included and accurate.

  3. Leaving out the license number. This is crucial for the verification process and must be filled in correctly.

  4. Neglecting to sign and date the application. Without your signature and the date, the form may be considered incomplete.

  5. Forgetting to attach necessary documents. This includes any required copies of findings or current massage therapy requirements from your state.

  6. Not checking the current status of your license. Ensure you accurately indicate whether your license is active, lapsed, inactive, denied, suspended, or revoked.

  7. Providing incorrect or outdated information about education requirements. Double-check the total hours and specific requirements for your state.

  8. Overlooking the importance of the typed name and title of the person completing Section II. This information is essential for verification.

Documents used along the form

When applying for a massage therapy license in Texas, several forms and documents may accompany the Massage License Texas Lookup form. Each of these documents plays a crucial role in verifying qualifications and ensuring compliance with state regulations. Below is a list of commonly used forms that applicants might encounter during the licensing process.

  • Massage Therapy License Application: This is the primary form that applicants fill out to initiate the licensing process. It includes personal information, educational background, and details about any prior licenses held.
  • Proof of Education: Applicants must provide documentation proving they have completed the required educational hours in massage therapy. This may include transcripts or certificates from accredited schools.
  • Background Check Authorization: A background check is often required to ensure the applicant has no disqualifying criminal history. This form authorizes the state to conduct the necessary checks.
  • Continuing Education Certificates: If the applicant has completed additional training or continuing education courses, certificates must be submitted to demonstrate ongoing professional development.
  • Verification of Licensure from Other States: For those who have held licenses in other states, this form verifies the status of those licenses. It ensures that the applicant meets Texas's requirements based on their previous licensure.

Completing these forms accurately and submitting the necessary documentation can significantly streamline the licensing process. Being well-prepared helps ensure that applicants meet all requirements and can begin their practice in Texas without unnecessary delays.

Similar forms

The Massage License Texas Lookup form serves as a crucial document for verifying a massage therapist's credentials. Several other documents share similarities in their purpose and structure, particularly in the context of professional licensing and verification. Below is a list of seven such documents, each with a brief description of how they relate to the Massage License Texas Lookup form.

  • State License Verification Form: Similar to the Massage License Texas Lookup, this form is used by various states to confirm the licensing status of professionals in fields such as nursing or teaching. It typically requires the applicant's consent to release their licensing information.
  • Out-of-State License Verification Form: This document is specifically designed for individuals seeking to verify their licenses from states other than where they currently practice. It often includes sections for both the applicant and the licensing authority to fill out, mirroring the structure of the massage license form.
  • Professional Certification Verification Form: Many professions, including counseling and therapy, require a certification verification process. This form confirms the individual's certification status, education, and any disciplinary actions, paralleling the requirements found in the massage therapy form.
  • Reciprocity Application Form: When professionals move between states, they often need to complete a reciprocity application. This form assesses whether the individual meets the requirements of the new state, similar to how the Massage License Texas Lookup form verifies qualifications.
  • Continuing Education Verification Form: This document is used to confirm that professionals have completed the necessary continuing education credits to maintain their licenses. It often requires the submission of specific coursework details, akin to the educational requirements in the massage form.
  • Employment Verification Form: While primarily used for job applications, this form often requires verification of professional licenses and credentials. It shares the need for both applicant and verifier signatures, much like the Massage License Texas Lookup.
  • Background Check Authorization Form: Many licensing processes involve a background check. This form authorizes the relevant authorities to conduct checks on an applicant's history, echoing the consent aspect found in the massage therapy licensing form.

Dos and Don'ts

When filling out the Massage License Texas Lookup form, there are important steps to follow. Here are four things to keep in mind:

  • Do type or print your information clearly to ensure it is legible.
  • Do provide your signature and the date to authorize the release of your information.
  • Don't leave any required fields blank, as this may delay the processing of your application.
  • Don't forget to attach any necessary documents, such as the current massage therapy requirements from your state.

Misconceptions

  • Misconception 1: The Massage License Texas Lookup form is only for new applicants.

    This form is also used for verifying licenses held in other states. Both new applicants and those seeking to transfer their licenses must complete it.

  • Misconception 2: The form does not require a signature from the applicant.

    The applicant must sign the form to authorize the release of their licensing information. This signature is crucial for processing the application.

  • Misconception 3: Only positive information about the applicant is released.

    The form allows for the release of all information, whether favorable or not. This ensures a complete verification process.

  • Misconception 4: The form can be submitted without additional documentation.

    Applicants must attach various documents, such as the current massage therapy requirements from their state. Missing documents can delay the process.

  • Misconception 5: The form is not necessary if the applicant has never held a license in another state.

    If an applicant has held any license in any state, this form is still required. It ensures that all relevant licensing history is considered.

Key takeaways

Here are key takeaways for filling out and using the Massage License Texas Lookup form:

  • The form is necessary for applicants who have held licenses in other states.
  • Section I must be completed by the applicant. Use clear typing or printing.
  • Include your full name, license number, signature, and date in Section I.
  • Provide your current address and telephone number, including the area code.
  • Section II is for the out-of-state licensing authority to fill out.
  • The out-of-state authority must verify your license status, including whether it is active, lapsed, or suspended.
  • Attach any required documents, such as findings of fact or current state massage therapy requirements.
  • Ensure that the out-of-state authority certifies the accuracy of the information provided.
  • Keep a copy of the completed form for your records before submission.