21 NCAC 30 .1003             INITIAL APPLICATION FOR licensure

A massage and bodywork therapy establishment seeking initial licensure shall submit an application on a form provided by the Board containing the information set forth in G.S. 90-632.11 and the following:

(1)           Ownership information, including:

(a)           type of ownership structure;

(b)           names, residence addresses, phone numbers, and email addresses of all persons who have an ownership interest in the establishment, including parent corporations; and

(c)           if the operator is not the owner, the operator shall provide the information required in Rule .1004.

(2)           Location information, including:

(a)           Physical address of the establishment, and mailing address if different;

(b)           Website address, if any; and

(c)           Business phone number.

(3)           Trade name of establishment, if different from owner's name;

(4)           List of all LMBTs hired as employees or contracted with as independent contractors to provide treatment to clients, if known, or, if not known, submit to the Board within 60 days following granting of a license to operate;

(5)           Copy of lease or name, address, phone number and email address of lessor, if establishment does not own its facility;

(6)           Copy of city or county business license, if required; and

(7)           Completed self-evaluation inspection report demonstrating compliance with Rule .1004.

History Note:        Authority G.S. 90-632.11; 90-632.13;

Eff. November 15, 2019.