A.R.S. tit. 32 ch. 42 — Arizona Revised Statutes Title 32 Chapter 42 — Massage Therapy

32-4201. Definitions In this chapter, unless the context otherwise requires: 1. "Board" means the board of massage therapy. 2. "Board recognized school" means a school that is any of the following: (a) Accredited to offer massage therapy education by an agency recognized by the secretary of the United States department of education. (b) If located in this state, offered by a community college or approved by the state board for private postsecondary education. (c) If located in another state or a Canadian province, approved by an agency similar to the state board for private postsecondary education. (d) A career technical education district program that is offered by a career technical education district as defined in section 15-391. 3. "Bodywork therapy" means massage therapy. 4. "Massage therapist" means a person who is licensed under this chapter to engage in the practice of massage therapy. 5. "Massage therapy" means the following that are undertaken to increase wellness, relaxation, stress reduction, pain relief and postural improvement or provide general or specific therapeutic benefits: (a) The manual application of compression, stretch, vibration or mobilization of the organs and tissues beneath the dermis, including the components of the musculoskeletal system, peripheral vessels of the circulatory system and fascia, when applied primarily to parts of the body other than the hands, feet and head. (b) The manual application of compression, stretch, vibration or mobilization using the forearms, elbows, knees or feet or handheld mechanical or electrical devices. (c) Any combination of range of motion, directed, assisted or passive movements of the joints. (d) Hydrotherapy, including the therapeutic applications of water, heat, cold, wraps, essential oils, skin brushing, salt glows and similar applications of products to the skin. 6. "Practice of massage therapy" means the application of massage therapy to any person for a fee or other consideration. Practice of massage therapy does not include the diagnosis of illness or disease, medical procedures, naturopathic manipulative medicine, osteopathic manipulative medicine, chiropractic adjustive procedures, homeopathic neuromuscular integration, electrical stimulation, ultrasound, prescription of medicines or the use of modalities for which a license to practice medicine, chiropractic, nursing, occupational therapy, athletic training, physical therapy, acupuncture or podiatry is required by law. 32-4202. Board of massage therapy; members; terms; compensation; immunity A. The board of massage therapy is established consisting of the following members appointed by the governor: 1. Two massage therapists who are residents of this state, who possess an unrestricted license to practice massage therapy in this state and who have been practicing in this state for at least five years immediately preceding their appointment. The governor may make these appointments from a list of names submitted by a statewide massage or bodywork therapy association, or both, or any other group or person. 2. Three public members who are residents of this state and who are not affiliated with and do not have any financial interest in any health care profession but who have an interest in consumer rights or have a background in compliance or law enforcement issues. At least one public member must be actively involved in programs or services that help to reduce or prevent human trafficking. B. Board members serve staggered five-year terms that begin and end on the third Monday in January. Board members shall not serve for more than two successive five-year terms or for more than ten consecutive years, except that the term of office for a member of the board appointed to fill a vacancy that occurs before the expiration of a full term is for the unexpired portion of that term, and the governor may reappoint that member to not more than two additional full terms. C. If requested by the board, the governor may remove a board member for misconduct, incompetence or neglect of duty. D. Board members are eligible to receive compensation in the amount of $100 per day for each day of actual service in the business of the board and for reimbursement of expenses pursuant to title 38, chapter 4, article 2 to cover necessary expenses for attending each board meeting or for representing the board in an official board approved activity. E. A board member who acts within the scope of board duties, without malice and in the reasonable belief that the member's action is warranted by law is not subject to civil liability. 32-4203. Board; powers and duties A. The board shall: 1. Evaluate the qualifications of applicants for licensure. 2. Designate at least one national examination that it requires applicants to pass. The examination must be available to a graduating massage therapy or bodywork therapy student within ninety days before the student's expected graduation date. The board shall require that an examination be processed and the results returned to the board within thirty days after the examination is administered. If, by October 20, 2005, the testing agency administering the examination fails or is unable to comply with the requirements of this paragraph, the board shall designate another examination for applicants to pass. 3. Issue licenses to persons who meet the requirements of this chapter. 4. Regulate the practice of massage therapy by interpreting and enforcing this chapter. 5. Establish education requirements for licensees and applicants, including identifying board-recognized schools and continuing education programs and assessing the continuing competence of licensees. 6. Adopt rules for ethical and professional conduct to govern the practice of massage therapy in this state. 7. Adopt rules to enforce this chapter. 8. Meet at least once each quarter in compliance with the open meeting requirements of title 38, chapter 3, article 3.1 and keep an official record of these meetings. 9. At its first regular meeting after the start of each calendar year, elect officers from among its members as necessary to accomplish board business. 10. Provide for the timely orientation and training of new professional and public appointees to the board regarding board licensing and disciplinary procedures, this chapter, board rules and board procedures. 11. Maintain a current list of all licensees that includes the licensee's name, current business address and telephone number and license number and that is regularly accessible in electronic format to public officials and agencies to verify the license status of licensees in this state. 12. Enter into contracts for services necessary to enforce this chapter. 13. Publish, at least annually, or make available for copying or reproduction in any format, final disciplinary actions taken against a licensee. B. The board may: 1. Accept and spend federal monies and private grants, gifts, contributions and devises to assist in carrying out the purposes of this chapter. These monies do not revert to the state general fund at the end of a fiscal year. 2. Administer oaths and affirmations, subpoena witnesses, take evidence and require the production of documents, records or information, either kept in original form or electronically stored or recorded, or other items relevant to a matter within the jurisdiction of the board. 3. For initial licensure, require a criminal background check, including the fingerprinting of every applicant for licensure, to assist the board in determining whether grounds exist to deny a license. 32-4204. Executive director; personnel; duties; compensation; immunity A. Subject to title 41, chapter 4, article 4 and section 32-3253, the executive director of the board of behavioral health examiners shall serve as the executive director of the board of massage therapy. The executive director may not be a member of the board of massage therapy and may not have any financial interests in the practice of massage therapy or the training of massage therapists. The board of massage therapy may authorize the executive director to represent the board of massage therapy and to vote on behalf of the board of massage therapy at meetings of national organizations of which the board of massage therapy is a dues-paying member. B. The executive director and other board staff are eligible to receive compensation as determined pursuant to section 38-611. C. The executive director or the executive director's designee shall: 1. Keep a record of the proceedings of the board. 2. Collect all monies due and payable to the board. 3. Deposit monies received by the board as prescribed by section 32-4205. 4. Prepare bills for authorized expenditures of the board and obtain warrants from the director of the department of administration for payment of bills. 5. Administer oaths. 6. Act as custodian of the seal, books, minutes, records and proceedings of the board. 7. At the request of the board, do and perform any other duty not prescribed for the executive director elsewhere in this chapter. D. The executive director shall attend all committee hearings of the house of representatives and senate health and human services committees, or their successor committees, relating to the auditor general's follow-up reports regarding the board's implementation status of the auditor general's performance audit and sunset review recommendations. E. Subject to title 41, chapter 4, article 4, the board may employ other personnel as it deems necessary to carry out the purposes of this chapter. F. The executive director and any person acting pursuant to the executive director's direction are personally immune from civil liability for all actions taken in good faith pursuant to this chapter. 32-4205. Board of massage therapy fund (L24, Ch. 222, sec. 51. Eff. until 7/1/28) A. The board of massage therapy fund is established. The board shall administer the fund. The board shall deposit, pursuant to sections 35-146 and 35-147, fifteen percent of all monies collected pursuant to this chapter in the state general fund and deposit the remaining eighty-five percent of the monies in the board of massage therapy fund. B. Monies deposited in the board of massage therapy fund are subject to section 35-143.01. 32-4205. Board of massage therapy fund (L24, Ch. 222, sec. 52. Eff. 7/1/28) A. The board of massage therapy fund is established. The board shall administer the fund. The board shall deposit, pursuant to sections 35-146 and 35-147, ten percent of all monies collected pursuant to this chapter in the state general fund and deposit the remaining ninety percent of the monies in the board of massage therapy fund. B. Monies deposited in the board of massage therapy fund are subject to section 35-143.01. 32-4221. Licensure; persons and activities not required to be licensed A. Beginning July 1, 2005, a person who wishes to engage in the practice of massage therapy must be licensed pursuant to this chapter and may submit an application for licensure pursuant to this chapter not sooner than the date prescribed by the board. B. This chapter does not apply to: 1. A health care professional who is licensed pursuant to this title and who practices within the scope of that person's license if that person does not claim to be a massage therapist or a bodywork therapist. 2. A person who is pursuing a course of study leading to a degree as a massage therapist in a professional education program that is approved by the board if all of the following apply: (a) The person is satisfying supervised clinical education requirements related to the person's massage therapy education while under the direct supervision of a licensed massage therapist. (b) The person is practicing in an education setting in this state that has been approved by the state board for private postsecondary education. (c) The person is practicing in an establishment, location or setting that complies with applicable municipal and county ordinances. (d) All persons who are present in the room during the delivery of massage services, other than a student and the customer, are licensed pursuant to this chapter or are health professionals as defined in section 32-3201. 3. A massage therapist who resides and is employed in another jurisdiction and who possesses the qualifications for licensure in this state if that person is performing massage therapy in this state in connection with teaching or is participating in an educational seminar. 4. The practice of massage therapy by a person who is employed by the government of the United States while the person is engaged in the performance of duties prescribed by the laws and regulations of the United States. 5. When the customer is fully clothed, the practice of movement educators, such as dance therapists or teachers, yoga teachers, personal trainers, martial arts instructors and movement repatterning practitioners. 6. When the customer is fully clothed, the practice of techniques that are specifically intended to affect the human energy field. C. A health care professional who is licensed pursuant to this title and who practices within the scope of that person's license is not required to be licensed pursuant to this chapter. D. This chapter does not require a person acting under the supervision of a person licensed pursuant to this title and permitted by this title to perform functions under the direction or supervision of that licensee to hold a license pursuant to this chapter. 32-4222. Qualifications for licensure A. An applicant for a license as a massage therapist shall: 1. Be at least eighteen years of age. 2. Be a citizen or legal resident of the United States. 3. Satisfy the requirements of section 32-4224. 4. Receive either a high school diploma or general equivalency diploma or a similar document or certificate or submit proof that the applicant has passed an ability to benefit examination recognized by the United States department of education. 5. Pay the fees established pursuant to section 32-4227. 6. Within five years preceding the date of the application for initial licensure, not have been convicted of a misdemeanor involving prostitution or solicitation or another similar offense involving moral turpitude that has a reasonable relationship to the practice of massage therapy. 7. Within the preceding five years, not have voluntarily surrendered a license under section 32-4254 or not have had a license to practice massage therapy or another similar license revoked by a political subdivision of this state or a regulatory agency in another jurisdiction in the United States for an act that occurred in that jurisdiction and that would be subject to discipline pursuant to this chapter. 8. Not be currently under investigation, suspension or restriction by a political subdivision of this state or a regulatory agency in another jurisdiction in the United States for an act that occurred in that jurisdiction and that would be subject to discipline pursuant to this chapter. If the applicant is under investigation by a regulatory agency in another jurisdiction, the board shall suspend the application process and may not issue or deny a license to the applicant until the investigation is resolved. 9. For initial licensure, submit a full set of fingerprints to the board for the purpose of obtaining a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. The board may charge the cost of each criminal background check to the applicant. 10. Beginning January 1, 2023, possess a valid fingerprint clearance card issued pursuant to title 41, chapter 12, article 3.1 for initial licensure, license renewal, a temporary license or license reinstatement pursuant to this chapter. B. In addition to the requirements of subsection A of this section, an applicant for licensure as a massage therapist shall either: 1. Have successfully completed a course of study of massage therapy or bodywork therapy consisting of a minimum of five hundred classroom and clinical hours of supervised instruction at a board recognized school in this state that is accredited by an agency recognized by the secretary of the United States department of education. 2. Have done both of the following: (a) Successfully completed a course of study in massage therapy or bodywork therapy consisting of a minimum of five hundred classroom and clinical hours of supervised instruction at a school in this state that is licensed by the state board for private postsecondary education or at a school outside of this state that is recognized by the board pursuant to section 32-4228. (b) Successfully passed an examination administered by a national board accredited by the certifying agency that has been approved by the national commission on competency assurance and that is in good standing with that agency or have successfully passed an examination that is administered or approved by the board. C. The board may adopt rules to allow it to consider the education and experience of an applicant who came from a foreign country. The board by rule may increase the minimum number of classroom hours of supervised instruction at a board recognized school that an applicant for licensure must successfully have completed. D. If the board is satisfied that an applicant meets the requirements of this section, the board shall issue a license to the applicant. E. Subject to the board's approval, the executive director may issue licenses to applicants who meet the requirements of this chapter. F. The board may deny an application for a license if the applicant committed an act that would subject a person licensed under this chapter to disciplinary action. 32-4223. Reciprocity A. An applicant is eligible for reciprocal licensure if either of the following applies: 1. The applicant has been licensed in another state that has comprehensive standards for licensure for massage therapists for at least two of the last five years preceding the filing of the application with the board. 2. The applicant holds a current certification from the national certification board for therapeutic massage and bodywork or another agency that meets the standards of the national organization on competency assurance and received education and training substantially equivalent to that required by this chapter. B. When an applicant submits an application for reciprocity, the applicant shall also submit a letter or other document acceptable to the board showing whether any jurisdiction that has previously certified or licensed the applicant has instituted disciplinary proceedings or has unresolved complaints pending against the applicant. If a disciplinary proceeding or an unresolved complaint is pending, the applicant shall not be licensed until the proceeding or the complaint has been resolved in the applicant's favor. 32-4224. Application; temporary licensure A. An applicant for licensure shall file a completed application under oath or affirmation containing the information required by the board. The applicant shall include the application fee as prescribed in section 32-4227. B. The executive director may issue a temporary license to an applicant who files a completed application, who meets the applicable qualifications prescribed in section 32-4222, subsection A, who has satisfactorily completed a course in massage therapy or bodywork therapy at an institution that is recognized by the board pursuant to section 32-4228 and who pays the prescribed application fee. A temporary license is not effective for more than one hundred eighty days and expires on the occurrence of any one of the following: 1. Issuance of a license by the board. 2. Denial of the application by the board. 3. Expiration of the term for which the temporary license was issued. 32-4225. License renewal; changes in personal information; notification; continuing education A. Except as provided in section 32-4301, a license issued pursuant to this chapter is subject to renewal every other year on the licensee's birthday and expires unless renewed. B. The executive director shall notify each licensee at least sixty days before expiration of the license and may renew the license on receipt of a completed renewal application. C. Each licensee is responsible for reporting to the board a name change and changes in business and home addresses and phone numbers within ten days after any change. D. Each licensee shall notify the board in writing within ten days after the issuance of a final order, judgment or conviction of a felony or other offense involving moral turpitude or prostitution, solicitation or any other similar offense. E. When a licensee renews a license, the licensee must provide the board with an affirmation of the successful completion of at least twenty-four hours of continuing education in the practice of massage therapy, as approved by the board, during the immediately preceding two years. 32-4226. Renewal of an expired license; reinstatement of a lapsed license A. Except as provided in section 32-4301, the board may renew an expired license on payment of a renewal fee and a delinquency fee and on proof that the applicant continues to meet all requirements for continuing competency and continuing education established by the board. B. The board may reinstate a lapsed license on payment of a renewal fee and a reinstatement fee and on proof that the applicant continues to meet all requirements for continuing competency and continuing education established by the board. C. If a person's license has lapsed for more than three consecutive years, that person shall reapply for a license and pay all applicable fees. The person shall also demonstrate to the board's satisfaction competency in the practice of massage therapy or shall serve an internship under a restricted license or take remedial courses as determined by the board, or both, at the board's discretion. The board may also require the applicant to take an examination. 32-4227. Fees A. The board shall establish and collect nonrefundable fees that do not exceed the following: 1. To apply for an original license, two hundred fifty dollars. 2. To renew a license, two hundred fifty dollars. 3. To reinstate a lapsed license, two hundred fifty dollars. 4. To renew a license after the expiration date of the license, a delinquency fee of one hundred twenty-five dollars. 5. For each duplicate license, fifty dollars. 6. For copying records, documents, letters, minutes, applications and files, twenty-five cents per page. B. The board shall charge additional fees for services not required to be provided by this chapter but that the board determines are necessary and appropriate to carry out this chapter. The fees shall not exceed the actual cost of providing these services. 32-4228. Massage therapy schools; recognition A. The board shall recognize a school of massage therapy located in this state if it is approved by the state board for private postsecondary education, is accredited to offer massage therapy education by an agency recognized by the secretary of the United States department of education or is a career technical education district program that is offered by a career technical education district as defined in section 15-391. B. The board shall recognize a school of massage therapy located in another state or a Canadian province if it is accredited or approved by an agency similar to the state board for private postsecondary education or it is accredited to offer massage therapy education by an agency recognized by the secretary of the United States department of education. C. Each school of massage therapy that is located in this state and that receives approval from the state board for private postsecondary education shall report to the board of massage therapy: 1. The physical address of the school and each instructional facility maintained or operated by the school. 2. All faculty and instructional staff, and all additions to or deletions from the faculty and staff. D. The board shall maintain a list of recognized schools. 32-4251. Lawful practice A. A massage therapist shall refer a person requiring a treatment for a condition outside the scope of practice of a massage therapist to one or more appropriate health care practitioners if the massage therapist has reasonable cause to believe symptoms or conditions are present that require services beyond the scope of practice of massage therapy or if massage therapy is contraindicated. B. A massage therapist shall adhere to the recognized standards and ethics of the massage therapy profession and as further established by rule. C. This chapter does not authorize a massage therapist to practice any other profession regulated under this title and does not expand the scope of practice of any health care provider who is not licensed pursuant to this chapter but who is licensed pursuant to this title. 32-4252. Use of title; restrictions; violation; classification A. No person may claim to be a massage therapist or use any terms or references in any advertisement, statement or publication to suggest to the public that the person is a massage therapist unless that person is a massage therapist licensed pursuant to this chapter. B. The board may adopt rules to implement this section including the identification of references that may be used only by persons licensed under this chapter or exempt from licensure under this chapter. C. A person who is not licensed pursuant to this chapter shall not use any of these titles or abbreviations or any other abbreviation or other words, letters, signs or figures to indicate that the person using the title is licensed pursuant to this chapter. D. An establishment or business that employs or contracts with persons who are licensed under this chapter shall not advertise on behalf of those persons unless the services are provided by or under the direct supervision of a person licensed pursuant to this chapter. E. A person or entity that violates this section is guilty of a class 1 misdemeanor. 32-4253. Disciplinary action; grounds; definitions A. The following are grounds for disciplinary action: 1. Failing to meet or maintain the requirements for an original license under section 32-4222, subsection A. 2. Using fraud, deceit or misrepresentation in obtaining or attempting to obtain a license or the renewal or reinstatement of a license. 3. Using drugs or intoxicating liquors to an extent that affects professional competency. 4. Being convicted of a felony or other offense involving moral turpitude or any conviction for prostitution, solicitation or another similar offense. A conviction by a court of competent jurisdiction is conclusive evidence of the commission of the crime. 5. Being found mentally incompetent by a court of competent jurisdiction until proof of recovery from the condition can be established. 6. Engaging in any act or practice in violation of this chapter or any board rule or aiding, abetting or assisting any other person in the violation of these provisions or rules. 7. Having a license or certificate revoked or suspended or any other disciplinary action taken or an application for licensure or certification refused, revoked or suspended by the proper authorities of another state, territory or country. 8. Committing an act of malpractice, gross negligence or incompetency. 9. Practicing as a licensee under this chapter without an active license. 10. Engaging in conduct that could result in harm or injury to the public. 11. Using fraud, deceit or misrepresentation when communicating with the general public, health care professionals or other business professionals. 12. Falsely holding out oneself as licensed or certified in any discipline of massage therapy without successfully completing training approved by the board in that specialty. 13. Practicing or offering to practice beyond the scope of the practice of massage therapy. 14. Engaging in the performance of substandard care by a massage therapist due to a deliberate or negligent act or failure to act, regardless of whether actual injury to the person cared for is established. 15. Engaging in sexual activity with a client. 16. Failing to adhere to the recognized standards and ethics of the massage therapy profession. 17. Charging unreasonable or fraudulent fees for services performed or not performed. 18. Aiding or abetting a person who is not licensed in this state and who directly or indirectly performs activities requiring a license. 19. Failing to report to the board any act or omission of a licensee or applicant or any other person who violates this chapter. 20. Interfering with an investigation or disciplinary proceeding by willful misrepresentation of facts or by the use of threats or harassment against any person to prevent that person from providing evidence in a disciplinary proceeding or any legal action. 21. Promoting an unnecessary device, treatment or service for the financial gain of the massage therapist or of a third party. 22. Providing massage therapy services that are in any way linked to the financial gain of a referral source. 23. Violating this chapter, board rules or a written order of the board. B. For the purposes of this section: 1. "Breast" means any portion of the female breast below a point immediately above the top of the areola. 2. "Sexual activity" means any of the following: (a) Sexual conduct. (b) Offering to engage in sexual conduct. (c) Making sexual advances, requesting sexual favors or engaging in other verbal conduct or physical contact of a sexual nature with a client. (d) Intentionally viewing a completely or partially disrobed massage therapy client in the course of treatment if the viewing is not related to treatment under current practice standards and is intended to appeal to the prurient interest of the massage therapy client or the massage therapist. (e) Massaging, touching or applying any instrument or device by a licensee in the course of practicing or engaging in massage therapy to the breasts of a female client unless the client requests breast massage and signs a written consent form. If the client is a minor, the consent form must include the signature of the client's parent or legal guardian authorizing the procedure and outlining the reason for the procedure before the procedure is performed. (f) Asking or directing a massage therapy client or prospective client to touch the client's own anus or genitals or to touch the anus, genitals or female breasts of any other person. (g) Asking or directing a massage therapy client or prospective client to expose the client's own anus or genitals to the massage therapist or any other person with the intention of appealing to the prurient interest of the massage therapy client or the massage therapist. (h) Exposing the massage therapist's anus or genitals to a client. (i) Exposing her breasts to a client. 3. "Sexual conduct" means any direct or indirect touching, fondling or manipulating of any part of the genitals or anus by any part of the body or by any object or causing a person to engage in that conduct. 32-4254. Investigative powers; emergency action; disciplinary proceedings; formal interview; hearing; civil penalty A. The board on its own motion may investigate any evidence that appears to show that a licensee is or may be incompetent or is or may be subject to discipline under this chapter. On written request of a complainant, the board shall review a complaint and take any action it deems appropriate. The board or the executive director shall notify the licensee as to the content of the complaint as soon as reasonable. A licensee shall, and any other person may, report to the board any information the person may have that appears to show grounds for disciplinary action against a licensee. Any person or entity that reports or provides information to the board in good faith is not subject to an action for civil damages. If requested, the board shall not disclose the name of a person who supplies information regarding a licensee's drug or alcohol impairment. It is an act of unprofessional conduct for any licensee to fail to report as required by this section. B. If the board finds, based on the information it receives under subsection A of this section, that the public health, safety or welfare requires emergency action and incorporates a finding to that effect in its order, the board may restrict, limit or order a summary suspension of a license pending proceedings for revocation or other action. If the board takes action pursuant to this subsection, it shall also serve the licensee with a written notice that states the charges and that the licensee is entitled to a formal hearing before the board or an administrative law judge within sixty days. C. If, after completing its investigation, the board finds that the information provided pursuant to subsection A of this section is not of sufficient seriousness to merit disciplinary action against the license of the licensee, the board or a board committee may take any of the following nondisciplinary actions: 1. Dismiss if, in the opinion of the board, the information is without merit. 2. File an advisory letter. The licensee may file a written response with the board within thirty days after receiving the advisory letter. 3. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment. D. If the board finds that it can take rehabilitative or disciplinary action without the presence of the licensee at a formal interview, it may enter into a consent agreement with the licensee to limit or restrict the licensee's practice or to rehabilitate the licensee, protect the public and ensure the licensee's ability to safely engage in the practice of massage therapy. The board may also require the licensee to successfully complete a board approved rehabilitative, retraining, continuing education or assessment program. E. If, after completing its investigation, the board believes that the information is or may be true, it may request a formal interview with the licensee. If the licensee refuses the invitation for a formal interview or accepts and the results indicate that grounds may exist for revocation or suspension of the licensee's license for more than twelve months, the board shall issue a formal complaint and order that a hearing be held pursuant to title 41, chapter 6, article 10. If, after completing a formal interview, the board finds that the protection of the public requires emergency action, it may order a summary suspension of the license pending formal revocation proceedings or other action authorized by this section. F. If, after completing the formal interview, the board finds the information provided under subsection A of this section is not of sufficient seriousness to merit suspension for more than twelve months or revocation of the license, it may take one or more of the following actions: 1. Dismiss if, in the opinion of the board, the complaint is without merit. 2. File an advisory letter. The licensee may file a written response with the board within thirty days after the licensee receives the advisory letter. 3. File a letter of reprimand. 4. Issue a decree of censure. A decree of censure is an official action against the licensee's license. 5. Fix a period and terms of probation best adapted to protect the public health and safety and to rehabilitate or educate the licensee concerned. Probation may include temporary suspension not to exceed twelve months or restriction of the licensee's license to practice massage therapy. If a licensee fails to comply with the terms of probation, the board shall serve the licensee with a written notice that states that the licensee is subject to a formal hearing based on the information considered by the board at the formal interview and on any other acts or conduct alleged to be in violation of this chapter or rules adopted pursuant to this chapter, including noncompliance with the terms of probation, a consent agreement or a stipulated agreement. 6. Enter into an agreement with the licensee to restrict or limit the licensee's practice in order to rehabilitate, retrain or assess the licensee, protect the public and ensure the licensee's ability to safely engage in the practice of massage therapy. 7. Order the payment of restitution, including an order to repay fees paid by a massage therapy client and for the cost of the investigation. 8. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment. G. If the board finds that the information provided in subsection A or E of this section warrants suspension or revocation of a license issued pursuant to this chapter, it shall initiate formal proceedings pursuant to title 41, chapter 6, article 10. If after a formal proceeding the board finds that a licensee has been convicted of prostitution, solicitation or another similar offense, the board shall revoke the license. H. A licensee shall respond in writing to the board within thirty days after notice of the hearing is served. The board may consider a licensee's failure to respond within this time as an admission by default to the allegations stated in the complaint. The board may then take any disciplinary action allowed pursuant to this chapter without conducting a hearing. I. In a formal interview pursuant to subsection E of this section or in a hearing pursuant to subsection G of this section, the board in addition to any other action may impose a civil penalty of not more than ten thousand dollars for each violation of this chapter or a rule adopted pursuant to this chapter. J. An advisory letter is a public document. K. A licensee who after a formal hearing is found by the board to be subject to discipline pursuant to this chapter is subject to censure, probation or restitution as provided in this section, suspension or revocation of license or any combination of these, including a stay of action, for a period of time or permanently and under conditions the board deems appropriate for the protection of the public health and safety and just in the circumstance. The board may charge the costs of formal hearings to a licensee whom it finds to be in violation of this chapter. L. If the board, during the course of any investigation, determines that a criminal violation involving the practice of massage therapy may have occurred, it shall make the evidence of a violation available to the appropriate criminal justice agency for its consideration. M. The board shall deposit, pursuant to sections 35-146 and 35-147, all monies it collects from civil penalties paid pursuant to this section in the state general fund. N. Notice of a complaint and hearing is effective by a true copy of it being sent by certified mail to the licensee's last known address of record in the board's files. Notice of the complaint and hearing is complete on the date of its deposit in the mail. The board shall begin a formal hearing within one hundred twenty days after that date. O. The board may accept the surrender of a license from a person who admits in writing to any of the following: 1. Being unable to safely engage in the practice of massage therapy. 2. Having committed an act subject to discipline pursuant to this chapter. 3. Having violated this chapter or a board rule. P. In determining the appropriate disciplinary action under this section, the board shall consider all previous nondisciplinary and disciplinary actions against a licensee. 32-4255. Unlawful practice; classification; civil penalties; injunctive relief A. It is unlawful for any person to practice or in any manner to claim to practice massage therapy or to advertise massage therapy services unless that person is licensed pursuant to this chapter. A person who engages in an activity requiring a license pursuant to this chapter or who uses any word, title or representation in violation of section 32-4252 that implies that the person is licensed to engage in the practice of massage therapy, or who advertises massage therapy services without being licensed pursuant to this chapter is guilty of a class 1 misdemeanor. B. The board may investigate any person to the extent necessary to determine if the person is engaged in the unlawful practice of massage therapy. If an investigation indicates that a person may be practicing massage therapy unlawfully, the board shall inform the person of the alleged violation. The board may refer the matter for prosecution regardless of whether the person ceases the unlawful practice of massage therapy. C. The board, through the appropriate county attorney or city attorney or the office of the attorney general, may apply for injunctive relief in any court of competent jurisdiction or enjoin any person from committing any act in violation of this chapter. Injunctive proceedings are in addition to all penalties and other remedies prescribed in this chapter. D. A person who aids or requires another person to directly or indirectly violate this chapter or board rules, who permits a license to be used by another person or who acts with the intent to violate this chapter or board rules is subject to a civil penalty of not more than one thousand dollars for each violation and not more than five thousand dollars for each subsequent violation. The board shall hold a hearing before it imposes this penalty. E. The board shall deposit, pursuant to sections 35-146 and 35-147, all monies it collects from civil penalties pursuant to this section in the state general fund. 32-4256. Reporting violations; immunity A. A person, licensee, corporation, educational institution, health care professional or health care facility and state or local governmental agencies must report to the board any conviction, determination or finding that a licensee has committed an act that constitutes grounds for disciplinary action pursuant to section 32-4253. B. A person is immune from civil liability, whether direct or derivative, for providing information in good faith to the board pursuant to subsection A of this section. C. The board shall not disclose the identity of a person who provides information unless this information is essential to proceedings conducted pursuant to sections 32-4254 and 32-4255 or unless required by a court. 32-4257. Third party reimbursement This chapter does not require direct third party reimbursement to any person licensed pursuant to this chapter. 32-4258. Regulation by county or municipality A. This chapter does not prohibit a county or municipality from adopting and enforcing regulations affecting the establishments, locations or settings in which individuals, entities or businesses engage in the practice of massage therapy. B. A county or municipality shall not impose regulations that are inconsistent with this chapter. 32-4259. Access to information; confidential information; display of license A. Any person has access to the following information: 1. A list of licensees that includes the licensee's place of practice, license number, date of license expiration and status of license. 2. A list of official actions taken by the board. B. Unless they are the only address and telephone number available, the home address and home telephone number of a massage therapist are not public records and the board shall keep this information confidential. C. Except in the course of a board investigation, information pertaining to the relationship between the massage therapist and a person treated by the massage therapist is confidential and may not be communicated to a third party who is not involved in that person's care without that person's prior written consent. If the person is a minor, the person's parent or guardian must also give written consent to these communications. D. The massage therapist must divulge to the board information it requires in connection with any investigation, public hearing or proceeding, including information that is otherwise confidential pursuant to this section. E. The privilege established by this section does not extend to cases in which the massage therapist has a duty to report information as required by law. F. The board shall provide access to the application, license, investigation and discipline files maintained by the board to law enforcement agencies and other regulatory agencies of this state. G. Each licensee shall display a copy of the licensee's license or current renewal verification in an establishment, location or setting that is accessible to public view at each location at which the licensee practices massage therapy. 32-4260. Advertising requirements; civil penalty; definitions A. A massage therapist or massage therapy business shall not advertise massage therapy services unless the advertisement includes either: 1. The massage therapy license number of the massage therapist if the advertisement is for the services of a specific massage therapist. 2. The business license number of at least one business license held by the massage therapy business if the advertisement does not offer the services of a specific massage therapist. B. A massage therapist or massage therapy business shall retain on file, for at least one year, proof of the age of any massage therapist whose services are offered in any advertisement of massage therapy services. C. A massage therapist or massage therapy business that violates this section is subject to a civil penalty of: 1. Five hundred dollars for a first violation. 2. One thousand five hundred dollars for a second violation. 3. Five thousand dollars for a third or subsequent violation. D. The attorney general, county attorney or city or town attorney may bring an action to enforce this section. E. The court shall deposit any civil penalties collected pursuant to subsection C of this section into the human trafficking victims assistance fund established by section 41-114. F. It is an affirmative defense in a civil action for a violation of subsection A of this section that the massage therapist or massage therapy business possessed a valid license at the time the advertisement was published. G. It is an affirmative defense in a civil action for a violation of subsection B of this section that the massage therapist whose services were offered in an advertisement for massage therapy services was eighteen years of age or older at the time the advertisement was published. H. For the purposes of this section: 1. "Advertisement" means any message in any medium that offers or solicits any person to retain the services of the massage therapist or massage therapy business depicted in the advertisement. 2. "Massage therapy business" means a person or business association that furnishes, offers to furnish or advertises the furnishing of massage therapists as one of its primary business purposes for any fee, tip or other consideration.