Massage School Program Approval, Re-Approval, or
Apprenticeship Application Packet
Contents:
1. 676-124 ......Contents List and Mailing Information ...........................................1 page
2. 676-125 ......Application Instructions ...............................................................3 pages
3. 676-126 ......Massage School Program/Apprenticeship Standards.................5 pages
4. 676-127 ......Massage School Program Approval, Re-Approval,
or Apprenticeship Application ......................................................2 pages
5. 676-117 ......Table of Contents ........................................................................3 pages
6. 676-128 ......Massage Program Courses Oered Form ....................................1 page
7. 676-138 ......Instructor/Trainer Resume ............................................................1 page
8. 676-139 ......Massage Program Course Syllabus............................................2 pages
9. RCW/WAC and Online Website Links ...............................................................1 page
Mail your completed application with documents to:
Board of Massage Training Program
P.O. Box 47852
Olympia, WA 98504-7852
Notify us by email when you mail in your binder at:
Contact us:
360-236-4700
Before you start: Watch the 30-minute video “How to Submit a Massage
School Program Application for Washington State Approval” for helpful instructions on
completing and submitting this application.
To request this document in another format, call 1-800-525-0127. Deaf or hard of
hearing customers, please call 711 (Washington Relay) or email [email protected].
DOH 676-124 December 2022
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Application Instructions Checklist
To expedite the review process, thoroughly review the following information and use the checklist to
make sure all the required documents are submitted:
- Only hard copy applications and documents will be accepted. Applications must
be submitted in a single 3-ring binder and organized in the order listed on the
Table of Contents provided. Electronic applications will not be accepted.
- All pages must be numbered and printed single sided only.
- Unless otherwise stated, templates that are included in this application must be
used. Documentation not provided on the templates will not be reviewed, and the
application packet will be considered decient.
- Only one binder needs to be submitted.
- In order to have ample review time, binders must be received no later than ve
weeks prior to a board meeting.
- All information must be typed or printed clearly in blue or black ink. You will be
notied in writing of any outstanding documentation needed to complete the
process.
- For helpful instructions on completing and submitting this application Watch the
30-minute video, “How to Submit a Massage School Program Application for
Washington State Approval.”
Use the following checklist to help guide you through the application:
F Select the type of application you are applying for on the rst page of the application:
• First time approval of Massage School/Program
• Re-approval of Massage School/Program
• First time approval of Massage Apprenticeship Program
• Re-approval of Massage Apprenticeship Program
F Legal Entity Type: check your legal owner/operator business structure type according to your
Washington State Master Business License. Additional information is on the
Department of Revenue website.
F 1. Demographic Information:
Uniform Business Identier Number (UBI number): Enter your Washington state UBI number.
All Washington State businesses must have UBI numberss. City, county, and state government
departments also have UBI numbers.
Federal ID Number (FEIN number): Enter your Federal ID Number, if the business has been
issued one.
Legal Owner/Operator Name: Enter the owner’s name as it appears on the UBI/Master
Business License.
Mailing Address: Enter the owner’s complete mailing address.
Phone, Fax and Cell Numbers: Enter the owner’s phone, cell, and fax numbers.
Email and Web Address: Enter the owner’s email and facility Web addresses, if applicable.
DOH 676-125 December 2022 Page 1 of 3
Facility/Agency Name: Enter the facility’s name as advertised on signs, brochures, or Web site.
Physical Address: Enter the facility’s physical street location including city, state, ZIP code, and
county.
Phone, Fax and Cell Numbers: Enter the facility’s phone, cell, and fax numbers.
Mailing Address: Enter the facility’s mailing address, if dierent from the physical address.
Authorized Representative Name: Enter the facility’s authorized representative’s name.
Authorized Representative Phone and Email: Enter the authorized representatives email and
phone.
F 2. Accreditation Information:
List if your school or program is accredited and provide attachments.
F 3. Program Information:
Provide the requested information about the program oered.
F 4. Program Representative Attestation:
The authorized program representative must sign and date this application.
Additional Information
The principal responsibility of the Board of Massage is to safeguard the public’s health and safety by
ensuring that licensed massage therapists are qualied to perform therapeutic massage, and that the
schools or apprenticeship programs where they study will provide the education they need to do so.
The board comprises ve licensed massage therapists, one massage educator, and one consumer
member of the public.
The process for considering your application is as follows:
• The application and documents are pre-reviewed by program sta. The pre-reviewer
will contact the school if there are any minor deciencies that can be easily corrected.
• The application is assigned and sent to two reviewing board members (RBMs) for
their review and evaluation.
• At an upcoming board meeting, the RBMs will make a recommendation based on
their review. The Board then votes to either approve, or send a deciency letter, or
deny program approval.
• Approval means that applicants for a massage therapy license who graduate from
the school during the school’s approval period will be eligible to take the massage
licensing examination.
• A deciency letter means the Board requires additional information from the school
prior to program approval.
• When an applicant sends additional information, the Board reconsiders the
application at a future Board meeting.
All completed massage school program or apprenticeship program application packets must be single
sided with numbered pages and submitted in a single three-ring binder. To be considered complete,
the application packet must contain the following:
• Completed massage school program/apprenticeship program application.
• Completed Table of Contents
• Supporting documents for each standard listed in the Table of Contents. The Table
of Contents must list the page numbers and each standard must be separated and
tabbed as follows:
DOH 676-125 December 2022 Page 2 of 3
DOH 676-125 December 2022 Page 3 of 3
- Standard One: Curriculum
- Standard Two: Academic Standards
- Standard Three: Faculty
- Standard Four: Student Clinic and/or Externships
- Standard Five: Health, Sanitation and Facilities
- Standard Six: Professional Conduct
- Standard Seven: Records
- Standard Eight: Eligibility
Schools accredited by the Commission on Massage Therapy Accreditation (COMTA) are not required
to submit standards 2, 5, 6, 7, or 8.
The Board may conduct a site review. To ensure continued compliance, periodic follow-up site
reviews may be conducted by the Board.
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Massage School Program/Apprenticeship Standards
To expedite the application process, read the instructions carefully. Applications must be complete and easy
to review. Application packets that are not submitted as outlined below will be considered decient and not be
forwarded to the reviewing board members until they are complete.
Use the following checklist to ensure that all documents are submitted and in
order:
F Completed Application form
F Completed Table of Contents form
Standard One—Curriculum
The curriculum shall be designed and presented to meet or exceed the minimum requirements in WAC 246-
830-430.
Standard One – Required Documentation:
DOH 676-126 December 2022 Page 1 of 5
A. Massage Program Courses Oered form: The applicant must list all courses taught
in the program and not just those that satisfy Washington’s minimum subject hour
requirements. The total hours of all courses oered must be the same as the total number
of hours listed on Page 2 of the Massage School Program Application form.
B. Course syllabi. Each course must have an individual syllabus. A template and a llable
template have been included. You may use the llable template or submit one using the
same outline of the llable template.
C. Sample or samples of mid-term, nal, or other equivalent exams for each of the following
subjects:
• Anatomy and physiology
• Pathology
• Kinesiology
• Practicum criteria
• Ethics and professionalism
• Laws and rules pertaining to massage
D. Statement regarding how a student will obtain rst aid and CPR training
E. Institutional philosophy or mission statement
Standard One Checklist – Curriculum
F Massage Program Courses Oered form
F Course syllabi which must be submitted using the llable template or a document using the
same outline. Any other format will not be accepted. Each course must have an individual
syllabus.
F Sample or samples of mid-term, nal, or other equivalent exams. Each exam must be clearly
labeled indicating what subject(s) are included on the exam. Each of the following subjects
must be covered in the exams:
- Anatomy and physiology
- Pathology
- Kinesiology
- Practicum criteria
- Ethics and professionalism
- Laws and rules pertaining to massage
F Statement on how a student will obtain rst aid and CPR training
F Institutional philosophy or mission statement
Standard Two – Academic Standards
School catalogs will not be accepted as proof of the required policies. Each policy must be clearly
titled and submitted individually.
Standard Two – Required Documentation
A. A statement or policy on minimum standards for measuring student progress
B. Policies and procedures for the following:
• Admission
• Progression
• Graduation
• Withdrawal
• Dismissal
• Nondiscrimination
Standard Two Checklist – Academic Standards
F A statement or policy on minimum standards for measuring student progress
F Policies and procedures for the following:
• Admission
• Progression
• Graduation
• Withdrawal
• Dismissal
• Nondiscrimination
Standard Three—Faculty:
Massage school program instructors or, an apprenticeship program trainer are required to be qualied
by training and experience to provide eective instruction in the subjects they are teaching.
DOH 676-126 December 2022 Page 2 of 5
Standard Three – Required Documentation:
A. A policy for ensuring minimum competency standards for instructors and a statement that
all massage school, massage program or apprenticeship program instructors meet those
standards (not necessary for apprenticeship programs)
B. A statement or policy describing faculty members’ participation in curriculum development
and evaluation (not necessary for apprenticeship programs)
C. A resumé for each instructor or trainer. Resumes must be submitted on the template
provided in this packet. Personal resumes will not be accepted
D. A listing of all instructors and the course(s) each instructor plans to teach.
Standard Three Checklist—Faculty
F Policy on minimum competency standards for instructors
F Statement or policy on faculty members’ participation in curriculum development and
evaluation
F Resumés for each instructor or trainer. Resumes must be submitted on the template
provided in this packet. Personal resumes will not be accepted.
F A listing of all instructors and the course(s) each instructor plans to teach.
Standard Four—Student Clinic
All clinical facilities are required to be adequate in size and resources for students to practice
massage on the general public. All rooms used for consultations, massage therapy or treatment are
required to be properly equipped with the resources needed to practice clinical hygiene procedures.
A faculty member who is a massage therapist with at least three-years of experience in massage
therapy must provide direct supervision as a clinical supervisor and makes nal decisions on the
massage therapy that is rendered to a client by a student. A faculty member in the role of a clinical
supervisor must ensure a ratio of no less than one faculty member to no more than six students who
are actively performing massage.
Standard Four—Required Documentation:
A. A statement that the student clinic is supervised by a faculty member who is a licensed
massage therapist with at least three years of practical experience in massage therapy
B. A statement that the faculty to student ratio in the student clinic is no less than one faculty
member to no more than six students who are actively performing massage
C. Policy or policies pertaining to the clinical supervisor's:
- review of the health history of the student’s client
- review and approval of the student’s massage plan
- observation of a reasonable portion of each massage session based on the competency
of the student
D. Disclosure statement form provided to clients
E. Client intake and screening form
F. Client feedback form
G. Supervisor feedback form
DOH 676-126 December 2022 Page 3 of 5
DOH 676-126 December 2022 Page 4 of 5
Standard Four Checklist—Student Clinic
F A statement that the student clinic is supervised by a faculty member who is a licensed
massage therapist with at least three years of practical experience in massage therapy
F A statement that the faculty-to-student ratio in the student clinic is no less than one faculty
member to no more than six students who are actively performing massage
F Policies pertaining to the clinical supervisor's:
• review of the health history of the student’s client
• review and approval of the student’s massage plan
• observation of a reasonable portion of each massage session based on the competency of
the student
F Disclosure statement form provided to clients
F Client intake and screening form
F Client feedback form
F Supervisor feedback form
Standard Five -- Health, Sanitation, and Facilities
All programs will have adequate facilities and equipment available for students learning massage
therapy. All facility equipment will be maintained according to local rules and ordinances governing
health and sanitation.
Standard Five—Required Documentation:
A. A statement that facilities are maintained in accordance with state and local ordinances
and rules governing health and sanitation
B. Detailed oor plan of the facility. This includes dimensions of the oor plan and labeled
photographs of the interior and exterior of the facility
C. Detailed oor plan of student clinic. This includes dimensions of student clinic and labeled
photographs
D. List of equipment available to students in the classroom
E. List of equipment available to students in the clinic
F. List of library contents and computer or online resources
Standard Five Checklist—Health, Sanitation, and Facilities:
F A statement that facilities are maintained in accordance with state and local ordinances and rules
governing health and sanitation
F Detailed oor plan of the facility including the following:
- dimensions of the oor plan
- labeled photographs of the interior of the facility
- labeled photographs of the exterior of the facility
F Detailed oor plan of student clinic including the following:
- dimensions of student clinic
- labeled photographs of student clinic
DOH 676-126 December 2022 Page 5 of 5
F List of equipment available to students in the classroom
F List of equipment available to students in student clinic
F List of library contents and computer or online resources
Standard Six—Professional Conduct
Approved educational programs will follow professional standards. Students will be taught and will
consistently practice professional draping techniques.
Standard Six—Required Documentation
Policies that outline faculty and student conduct
Standard Six Checklist—Professional Conduct
F Policies that outline faculty and student conduct
Standard Seven—Records
Records must be stored in a secured location and be made available upon a student’s written
request. The program transcript must provide adequate information to conclude that the student has
successfully completed the approved educational program.
Standard Seven——Required Documentation
A. Sample transcript
B. Policy on release of student records consistent with applicable laws
Standard Seven Checklist—Records (not required if COMTA approved)
F Sample transcript
F Policy on release of student records consistent with applicable laws
Standard Eight—Eligibility
Washington massage schools must be eligible to operate under one of the following options:
• Is approved to operate in the state of Washington by the workforce training and education
coordinating board, or
• Is licensed by private vocational education, or
• Is part of a college or university that is nationally or regionally accredited.
Standard Eight—Required Documentation
• Copy of the certicate of approval to operate this program.
Standard Eight Checklist—Eligibility
F Copy of Washington State Workforce Training Education Coordinating Board Certicate, or
F Verication that the school is licensed by private vocational education (see chapter 28C.10
RCW or Title 28B RCW), or
F Verication that the program is part of a college or university that is nationally or regionally
accredited.
DOH 676-127 December 2022 Page 1 of 2
Date
Stamp
Here
Massage School Program or Apprenticeship Application
F New Massage School/Program F New Apprenticeship Program
F Re-approval Massage School/Program F Re-approval of Apprenticeship Program
Application for:
F Association F Limited Partnership F Sole Proprietor
F Corporation F Municipality (City) F State Government Agency
F Federal Government Agency F Municipality (County) F Tribal Government Agency
F Limited Liability Company F Non-Prot Corporation F Trust
F Limited Liability Partnership F Partnership
1. Demographic Information
UBI number Federal Tax ID (FEIN) number
Legal Owner/Operator Name
Mailing Address
City State ZIP Code County
Legal Entity Type
School or Program Name (Business name as advertised on signs or Web site)
Physical Address
City State ZIP Code County
Phone (enter 10-digit number) Cell (enter 10-digit number) Fax (enter 10-digit number)
Mailing Address
City State ZIP Code County
Authorized Representative Name
Contact Email Program/apprenticeship Web Address
Authorized Representative Email
Authorized Representative Phone
2. Accreditation Information
Is your school approved by the Commission on Massage Therapy Accreditation (COMTA) or does your school hold
any other federally approved accreditations?
F Yes F No
If yes, please list them. Attach copies of documentation verifying accreditation, including the agency’s name,
address and date accreditation was issued.
3. Program Information:
Program Title
Length of Program Hours
Name of Certicate oered
Maximum faculty to student ratio
Name of Authorized Representative
In classroom
Date (mm/dd/yyyy)
DOH 676-127 December 2022 Page 2 of 2
Provide the following information about the program oered.
Weeks
In student clinic or externship
4. Program Representative Attestation:
I attest that I am the authorized representative of the above-named school or program, and that I am submitting this
application for approval by the Washington State Board of Massage in that capacity. I have become familiar with the
laws relating to Massage Therapists in chapter 18.108 RCW and chapter 246-830 WAC.
I have reviewed the board’s standards for approval and understand that this application will not be considered by
the board if it is incomplete. I understand that a future site visit may be required. Once approved, any modication(s)
to the program must be reported to the board within 30 days of the modication per WAC 246-830-420(5)(c).
Title
Signature of Authorized Representative
Massage Credentialing
P.O. Box 47877
Olympia, WA 98504-7877
360-236-4700
Massage School Program or Apprenticeship Application Page
Table of Contents Pages
Standard 1: Curriculum
Tab 1
A. Massage Program Courses Oered spreadsheet Page(s)
B. Course syllabi using either the llable template provided in this application packet
or following the same outline of the template.
Pages
C. Sample or samples of mid-term, nal, or other equivalent exams for each of the
following:
• Anatomy and physiology
• Pathology
• Kinesiology
• Practicum criteria
• Ethics and professionalism
• Laws and rules pertaining to massage
Pages
D. A statement regarding how a student will obtain First Aid and CPR certication Page
E. Institutional philosophy or mission statement Page
Standard 2: Academic Standards
Tab 2
A. A statement or policy dening the minimum standards for measuring student
progress
Page
B. Copies of policies and procedures for:
• Admission
• Progression
• Graduation
• Withdrawal
• Dismissal
• Nondiscrimination
Page
Standard 3: Faculty
Tab 3
A. Policy on minimum competency standards for instructors and a statement that
all massage school, massage program or apprenticeship program instructors
meet those standards
Page
Massage School Program or Apprenticeship Application
Table of Contents
DOH 676-117 December 2022 Page 1 of 3
B. A statement or policy on faculty members’ participation in curriculum
development and evaluation
Page
C. A resumé for each instructor or trainer using the template provided in the
application packet
Pages
D. A list of all instructors and the course(s) each instructor plans to teach Page(s)
Standard 4: Student Clinic
Tab 4
A. A statement that the student clinic is supervised by a faculty member who is a licensed
massage therapist with at least three-years of practical experience in massage therapy
Page
B. A statement that the faculty to student ratio in the student clinic is no less than one faculty
member to no more than six students who are actively performing massage
Page
C. Policy or policies pertaining to the clinical supervisor’s:
• review of the health history of the student's client
• review and approval of the student's massage plan
• observation of a reasonable portion of each massage session based on the
competency of the student
Pages
D. Disclosure statement form provided to clients
Page
E. Client intake and screening form
Page
F. Client feedback form
Page
G. Supervisor feedback form
Page
Standard 5: Health, Sanitation and Facilities
Tab 5
A. A statement that facilities are maintained in accordance with state and local ordinances and
rules governing health and sanitation
Page
B. Detailed oor plan of the facility that includes the following:
• dimensions of the facility’s oor plan
• labeled photographs of the interior of the facility
• labeled photographs of the exterior of the facility
Pages
C. Detailed oor plan of student clinic that includes the following;
• dimensions of the student clinic
• labeled photographs of the student clinic
Pages
D. List of equipment available to students in the classroom
Page
E. List of equipment available in the student clinic
Page
F. List of library contents and computer or online resources
Page
Standard 6: Professional Conduct
Tab 6
A. Policies on faculty and student conduct
Page(s)
DOH 676-117 December 2022 Page 2 of 3
Standard 7: Records
Tab 7
A. Sample transcript
Page
B. Policy on release of student records consistent with applicable law(s)
Page
Standard 8: Eligibility
Tab 8
- Copy of Washington State Workforce Training and Education Coordinating
Board Certicate, or
- Verication that the school is licensed by private vocational education, or
- Verication that the program is part of a college or university that is
nationally or regionally accredited
Page
DOH 676-117 December 2022 Page 3 of 3
A. Sample transcript and certicate of completion
Page
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DOH 676-128 December 2022
Board of Massage
PO Box 47852
Olympia, WA 98504-7852
360-236-4700
Massage Program Courses Offered
Attach additional sheets if necessary
Name of school/program Total Program Hours
Subject Area WAC 246-830-430
Anatomy &
Physiology
(90 Hours)
Kinesiology
(60 Hours)
Pathology
(70 Hours)
Theory &
Practice
(260 Hours)
Student
Clinic
(50 min to
75 max)
Clinical/
Business
Practices
(55 Hours)
Professional
Ethics
(40 Hours)
All other
courses
COURSE
TOTAL
(must
match
syllabus)
Course Title Page
Number
Course Hours Course Hours Course Hours Course Hours Course Hours Course Hours Course Hours Course Hours
Subject Area Total
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Massage Credentialing
PO Box 47877
Olympia, WA 98504-7877
360-236-4700
Instructor/Trainer Resume
A separate resume must be submitted for each instructor/trainer.
DOH 676-138 December 2022
Name
Professional License Information
License Number
Original Issuance Date
Expiration Date
License Status
Professional Education
List in date order all your educational preparation and post-graduate training. Attach
additional pages if necessary.
School Program Name
Date Degree or
Certicate Issued
Employment/Experience
List in date order all your employment and experience relevant to what you will be
teaching in the program. Attach additional pages if necessary.
Employer and Type of Experience
Dates Worked
(mm/yy – mm/yy)
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Massage Credentialing
PO Box 47877
Olympia, WA 98504-7877
360-236-4700
Massage Program Course Syllabus Template
Please read carefully:
There must be a separate syllabus for each course listed on the Table of Courses oered
form. You may either use the llable Word document or create your own syllabus using the
format on this Template.
If you create your own syllabus, each section must be clearly labeled.
Course Title
Subject Matter(s) as provided in WAC 246-830-430(1)(a)-(g)
(This must match what is listed on the table of courses oered
form)
No. of Hour(s) Per
Subject
Total Course Hours
Instructor(s) Name(s)
Measurable Course Objectives
Methods of Evaluation
Course Schedule
Textbooks and Other Instructional Materials
DOH 676-139 December 2022
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RCW/WAC Links
Chapter 18.108 RCW, Massage Therapists
Chapter 246-830 WAC, Massage Therapists
Chapter 18.130 RCW, Uniform Disciplinary Act
Chapter 34.05 RCW, Administrative Procedure Act
Chapter 246-12 WAC, Administrative Procedures and Requirements for
Credentialed Health Care Providers
Online
Board of Massage webpage
Washington Workforce Training & Education Coordinating Board
RCW/WAC and Online Website Links
RCW/WAC and Online Website Links December 2022
