Where You May Practice

About 28 minutes · ss. 480.046(1)(o), 480.047(1)(b), 480.043(15), 480.052 and 456.035, F.S.; Rules 64B7-23.001(11) and 64B7-23.011(12), F.A.C.

11.1 Two questions about location

Chapter 3 asked what counts as massage therapy and who may do it. This chapter asks where. The location of your work matters for two separate legal reasons.

First, the Act ties licensure to places as well as people. Chapter 2 explained that an "establishment" is any site or premises, or portion of premises, where a massage therapist practices massage therapy, and that both the therapist and the establishment are licensed. A therapist who performs massage therapy in a place that is neither a licensed establishment nor a permitted exception violates the Act, even if the therapist's own license is in good standing.

Second, a licensed therapist must tell the State where to find them. The Department communicates by mail to the address you have on file, and the law treats that mail as notice whether or not you received it.

This chapter covers where you may practice and how you report it. How an establishment obtains and keeps its license is Chapter 12, and the rules that govern what happens inside one are Chapter 13.

11.2 The general rule: a licensed establishment

Two provisions work together.

Section 480.046(1)(o) makes it a ground for discipline to practice massage therapy "at a site, location, or place which is not duly licensed as a massage establishment," subject to exceptions listed in the same paragraph.

Section 480.047(1)(b) makes it unlawful for any person to "operate any massage establishment unless it has been duly licensed as provided herein," with a carve-out for teaching massage therapy at a board-approved school. (The penalties for violating s. 480.047 are covered in Chapter 20.)

The first provision is aimed at the therapist who practices in an unlicensed place. The second is aimed at whoever operates the place. The same facts can implicate both: a therapist who works in an unlicensed room, and the person running it.

Because the definition of establishment includes a "portion" of premises, the rule reaches treatment rooms inside salons, gyms, offices and clinics. It also reaches a room in your own home. The statute's exceptions (Section 11.4) do not include the therapist's home, so a therapist who wants to see clients at home must operate a licensed establishment there. Zoning and other local rules may also apply (Section 11.11).

11.3 The five settings and the closed list

The statute names five settings in which a therapist may provide massage therapy without an establishment license. The list is short and easy to memorize, but each item raises practical questions. The table below sets out the five settings and the questions each one invites. It also repeats the one service that is excluded from all of them.

Colonic irrigation is excluded from all five. The statute says "excluding colonic irrigation," so even a therapist who is certified may not provide that service at any of these places. It requires a licensed establishment that meets the equipment and sterilization standards of the Board's rules.

A closed list works differently from an open one. When a list is open, a reader asks whether a new place is similar to the places listed. When a list is closed, a reader asks only whether the place is on the list. A park, a hotel lobby, a gym, a friend's house when the friend is not the client, a private party venue and a retail store are not on the list. If a place is not on the list, the therapist needs a licensed establishment.

The list also describes a pattern. Two of the settings, the client's residence and the client's office, are places where the therapist goes to the client. The other three are events, where many people gather and an organizer is in charge. Neither pattern includes a place that the therapist controls and where clients come to her. That pattern, a place the therapist controls and to which clients come, is exactly what the establishment license regulates.

11.4 The exceptions: where you may work without an establishment license

Section 480.046(1)(o) adds that "a massage therapist, as provided by board rule, may provide massage therapy services, excluding colonic irrigation," at five kinds of places:

1. The residence of a client.
2. The office of the client.
3. A sports event.
4. A convention.
5. A trade show.

Three features of this list deserve attention.

It is a closed list. The statute names five settings. Other places are not authorized by this paragraph, however convenient they may be. A park, a private party venue, a gym, a retail store or a therapist's own home is not on the list.

The client's place, not yours. Settings (1) and (2) are places that belong to the client: the client's residence or the client's office. The therapist goes to the client. The list does not authorize a therapist to set up a business at a location the therapist controls without an establishment license. Whether a hotel room occupied by a client counts as the client's "residence" is not defined in the Act or in the rule text we reviewed. If your work involves that kind of arrangement, ask the Board before relying on the exception.

Colonic irrigation is excluded. The words "excluding colonic irrigation" mean that even in these settings the service may not be provided. Colonic irrigation (certification in Chapter 7) may be performed only in a licensed establishment, which must also meet the equipment and sterilization standards in the Board's establishment rule (Chapter 13).

Other practitioners' offices. Section 480.043(15) provides a different kind of accommodation. It says that, apart from the human-trafficking reporting requirement in subsection (13) (Chapter 15), the establishment licensing section "does not apply to a practitioner licensed under chapter 457 or a physician licensed under chapter 458, chapter 459, or chapter 460 who employs a licensed massage therapist to perform massage therapy on the practitioner's or physician's patients at her or his place of practice." In other words, an acupuncturist (chapter 457), a medical physician (chapter 458), an osteopathic physician (chapter 459) or a chiropractic physician (chapter 460) who employs a licensed therapist to treat the practitioner's own patients at the practitioner's own practice does not need a separate massage establishment license for that arrangement. Three limits apply: the therapist must be licensed, the patients must be the practitioner's patients, and the work must be at the practitioner's place of practice. The subsection adds that it "does not restrict investigations by the department for violations of chapter 456 or this chapter."

Teaching. Section 480.047(1)(b) also provides that nothing in the establishment-licensing prohibition "shall be construed to prevent the teaching of massage therapy in this state at a board-approved massage therapy school." Instruction in an approved school's program does not require the school to hold a separate establishment license for that teaching.

11.5 Out-call practice: working at the client's place

Out-call work, in which the therapist travels to the client, is lawful under the statute's exception for the client's residence and office. It is also a form of work that carries special responsibilities, because the therapist leaves the structure of an establishment and takes on its tasks herself. The practices below help a therapist to work lawfully and safely in someone else's space.

Confirm the setting before you travel. Before the first visit, ask where the session will take place. A session in the client's own home or office fits the exception. A request to meet at a location that is not the client's, such as a rented room, a friend's home or a public venue, does not. Decline politely and explain that the law limits where you may provide the service, and offer a lawful alternative, such as the client's own home or a licensed establishment.

Do the assessment and consent as you would anywhere. The duties described in Chapter 10 do not change. You must still assess before treatment, obtain informed consent, drape appropriately and keep a record. Out-call work often involves a first meeting in an unfamiliar place, so be ready to explain your process clearly and to adapt to the setting.

Prepare the space. Bring the supplies you need, including sheets, towels, a table or chair and a drape of adequate size. Ask the client to prepare a quiet, private area with enough room. If the space is not suitable, you may decline to proceed.

Think about safety. An out-call therapist works alone in a place she does not control. Many therapists share their schedule with a trusted person, confirm bookings through a reliable process and trust their judgment. If a situation feels unsafe, leave. No fee is worth risking your safety, and a therapist may always decline to continue.

Keep records securely. Notes and intake forms that travel with you are vulnerable to loss. Use a secure method, such as a locked case or an encrypted device, and bring only what you need. The confidentiality duties of section 456.057 apply wherever the records are.

Set clear boundaries on services. The exception covers massage therapy and excludes colonic irrigation. Do not offer any service outside your scope. Be careful about advertising, as Chapter 17 explains.

Report your address correctly. A therapist who practices exclusively at clients' residences and offices, or at events, may report her own residential address as her place of practice. A therapist who practices partly in an establishment should follow the rule that applies to that setting. Update the Department promptly when anything changes.

Think about insurance and business registration. This course does not cover insurance or local business registration in detail, but a therapist who works on her own should ask her local government what registration it requires and should consider whether liability coverage is appropriate. Do not assume that a state license replaces local requirements.

11.6 Events: written approval first

Sports events, conventions and trade shows are three of the five exception settings, and the Board's rule on misconduct adds a condition. Under Rule 64B7-23.011(12), it is misconduct to offer massage therapy at a sporting event, convention or trade show "without obtaining the property manager of the site or the organizer of an event.">written approval of the owner or property manager of the site of the sporting event, convention or trade show or the organizer of the sporting event, convention, or trade show."

That creates a practical checklist for event work:

• Get permission in writing. An email or letter from the owner or property manager of the site, or from the organizer of the event, satisfies the rule. A verbal "sure, set up in the corner" does not.
• Keep it. The approval is your proof if anyone questions your presence.
• Ask before you offer. The rule speaks of offering massage without approval, so advertising or inviting people to a table before you have approval is itself a problem.
• Respect the other limits. The event exception does not include colonic irrigation, and everything in Chapter 10 about assessment, consent, draping and records still applies, even in a hallway at a convention. (Chapter 18 shows how the Board treats a failure of this approval requirement.)

11.7 Working an event, step by step

Events are exciting and good for business, and they are also a place where careless planning can produce complaints. The following sequence helps a therapist to prepare.

Step one: identify who can approve. The rule names the owner or property manager of the site of the event, or the organizer of the event. Find out who holds that authority. A volunteer, a vendor next to you or a staff member without authority is not the person who can approve.

Step two: ask in writing and receive in writing. Send a short request that says who you are, that you hold a Florida massage therapist license, what service you plan to offer, where you propose to set up and the dates and times. Ask the approver to reply in writing. An email or a letter satisfies the rule, according to the text reviewed for this course, and a verbal "sure" does not.

Step three: read the reply for conditions. The approval may set limits on space, hours, signage or the services you may offer. Follow every condition. If the reply is ambiguous, ask a follow-up question and keep the answer.

Step four: keep the approval at the event. Keep a copy where you can find it, on paper or on a device. If a manager, a security officer or another vendor questions your presence, you can show it.

Step five: plan the practical details. Decide how you will assess clients, obtain consent, drape and keep records in a short session. Chair massage over clothing is common at events. The Board's definition of a drape includes clothing, so a client who remains clothed is draped by her clothing, and you should still explain what you will do and obtain agreement. Prepare a brief intake that screens for contraindications, and be ready to decline a client for whom the treatment is not appropriate.

Step six: exclude colonic irrigation, and watch your claims. The event exception does not include colonic irrigation. Make sure that your signs and conversation describe what you offer accurately and make no claims that massage cures disease.

Step seven: protect privacy. Events are public. Keep records out of sight, avoid discussing a client's condition where others can hear and store any forms securely when you leave.

Step eight: follow up. Thank the organizer, record what happened and keep the approval with your business records. If you hope to return next year, a good record of the event helps you ask again.

11.8 Working in a physician's or acupuncturist's office

Section 480.043(15) allows an acupuncturist, a medical physician, an osteopathic physician or a chiropractic physician to employ a licensed massage therapist to treat that practitioner's own patients at the practitioner's place of practice, without a separate massage establishment license for that arrangement. The provision is narrow, and a therapist who works in such a setting should understand its limits.

Three conditions. The therapist must be licensed. The patients must be the practitioner's own patients. And the work must be at the practitioner's place of practice. A therapist who sees the clinic's patients in a satellite location, or who takes clients who are not patients of the practitioner, falls outside the exception.

The human trafficking reporting duty still applies. The subsection excepts the human-trafficking reporting requirement in subsection (13), which Chapter 15 explains. The establishment-licensing section does not apply, but the reporting duty does.

The Department may still investigate. The subsection states that it does not restrict investigations by the Department for violations of Chapter 456 or Chapter 480. A therapist in a clinic is subject to the same standards as any other licensee.

The therapist's own duties are unchanged. She must hold an active license, practice within her scope, assess before treatment, obtain informed consent, drape appropriately and keep records. A physician's employment does not enlarge her scope, as Chapter 3 explained, and she may not diagnose or prescribe because she works in a medical office.

Questions to ask the employer. Who is the records owner under the contract? How will patient information be shared between the clinic's providers, and what written authorization is needed? What services are you expected to provide? Who supervises the schedule? The answers affect your duties under section 456.057 and your exposure if something goes wrong.

The address you report. The rule allows the therapist to report the office of the physician or practitioner as her place of practice, so long as she is treating that practitioner's patients.

11.9 Telling the State where you are

Practitioners often forget that the State's ability to reach them depends on information they supply. Section 456.035, the "mailing address the licensee has given to the Department.">address of record" statute, sets the rules.

Your duty. Each licensee "is solely responsible for notifying the department in writing of the licensee's current mailing address and place of practice, as defined by rule of the board." Notice the word solely. The Department has no duty to track you down. Electronic notification is permitted, but "it shall be the responsibility of the licensee to ensure that the electronic notification was received by the department." If you submit an update online and the system fails to record it, the risk is yours; keep confirmation.

The consequence of failing. A licensee's failure to notify the Department of a change of address "constitutes a violation of this section, and the licensee may be disciplined by the board."

Notice by mail. Under s. 456.035(2), "service by regular mail to a licensee's last known address of record with the department constitutes adequate and sufficient notice to the licensee for any official communication to the licensee by the board or the department," except where s. 456.076 requires other service (the impaired practitioner provisions, Chapter 19). The practical effect: if the Department mails a notice of complaint, a renewal notice or an administrative complaint to your address of record, the law treats you as having been notified, even if you moved and never got it. Missing a deadline because mail went to an old address is not a defense.

What counts as a "place of practice." Rule 64B7-23.001(11) defines it as "any place in which a massage therapist provides massage therapy treatment to a patient." For reporting under s. 456.035, the rule lets a therapist use:

• (a) the address of the massage establishment where the therapist is currently employed; or
• (b) the address of the office of a physician or practitioner licensed under Chapter 457, 458, 459 or 460, so long as the therapist is providing treatment to that practitioner's patients (the rule cites the provision that is now s. 480.043(15)); or
• (c) if the therapist practices exclusively at the residences of patients, the offices of patients, or at sporting events, conventions or trade shows under s. 480.046(1)(o), the therapist's own residential address.

If you work in more than one place, keep your information current for each change. When you move your mailing address, change establishments, or begin or stop an out-call practice, update the Department promptly and in writing.

11.10 An address-of-record routine

The address statute is one of the simplest in the Act and one of the most often violated. A short routine makes compliance easy.

Know what you must report. The statute requires the licensee to notify the Department in writing of her current mailing address and place of practice. The mailing address is where the Department will send notices. The place of practice is where you provide treatment. For some therapists these are the same, and for others they differ.

Choose the right place-of-practice address. The rule lets a therapist use the address of the establishment where she is currently employed, the address of the physician's or practitioner's office where she treats that practitioner's patients, or, if she practices exclusively at residences, offices or events under the exception, her own residential address. If your situation does not match any of these, ask the Department.

Update when anything changes. Moving, changing employers, starting or stopping an out-call practice, and changing a mailing address are all triggers. Make a habit of updating the Department before the change takes effect, or immediately after.

Update in writing and keep proof. Electronic notification is permitted, but the licensee is responsible for ensuring it was received. Take a screenshot or save a confirmation. If you send a letter, use a method that provides proof of delivery.

Do not rely on forwarding. A postal forwarding order may send mail to your new home for a time, but it is not notice to the Department, and it expires. The law counts mail sent to your last address of record as notice to you.

Check at renewal. Before each renewal, confirm that your address of record is current. Renewal notices and other communications go there.

Tell the people who rely on you. If you work for an establishment, tell the owner your current address, because an owner may also need to know where to reach you.

11.11 State law and local law

Chapter 1 placed local ordinances at the bottom of the hierarchy of law. Section 480.052 states how they fit with the state Act:

"A county or municipality, within its jurisdiction, may regulate persons and establishments licensed under this chapter. Such regulation shall not exceed the powers of the state under this act or be inconsistent with this act. This section shall not be construed to prohibit a county or municipality from enacting any regulation of persons or establishments not licensed pursuant to this act."

Three rules emerge from that text.

1. Cities and counties may add regulation of licensed persons and places. Typical subjects include zoning (where a business of a given type may be located), business tax receipts or local registration, signage, building and fire codes, and hours or conduct rules.
2. They may not go beyond the state, or conflict with it. A local ordinance cannot claim powers the Act does not give the state, and cannot be inconsistent with the Act. If a city tried to authorize something the Act forbids, or forbid something the Act specifically allows, the state Act would control (Chapter 1).
3. They may regulate the unlicensed too. The final sentence preserves local authority over persons and establishments not licensed under the Act, for example businesses that are not massage businesses at all.

The Act itself acknowledges local law in specific places. For example, the window-visibility rules do not apply where a local ordinance's requirements on window light or signage would conflict (s. 480.043(14)(b)), the midnight-to-5 a.m. closing rule has an exception for special events approved by the county or municipality (s. 480.0475(1)(c)), and a person may let an establishment be used as living quarters if it is zoned residential under a local ordinance (s. 480.0475(2)). (Chapter 13 covers those provisions.) The pattern is that the Act sets the floor and defers to local authority only where it expressly says so.

For a therapist, the lesson is to check two layers before choosing a site: the state licensing requirements and the local zoning and licensing rules for that address. Compliance with one does not satisfy the other.

11.12 Checking local rules before you sign a lease

A therapist who plans to open an establishment, or to practice from a location she controls, should check local rules before she signs a lease or buys equipment. A site that is lawful under state licensing may still be unusable under local zoning, and discovering that after the lease is signed is expensive.

A sound approach is to ask the same questions at each local government that has authority over the address, usually the city, if the site is inside one, and the county.

Zoning. Is the address zoned for the use you propose? Zoning rules say what types of business may operate where. Ask the planning or zoning office whether a massage establishment is permitted at the address, and whether conditions apply.

Local business registration. Does the local government require a business registration or tax receipt? Ask what is required, who must obtain it and how often it renews. State licensing does not replace it.

Building and fire codes. Does the space meet building, fire and accessibility requirements for the use? Ask whether an inspection is required before opening.

Signage. Are there limits on signs, including their size, lighting and placement? The Act itself defers to local rules in specific cases involving window light and signage, as the chapter explained.

Hours and conduct rules. Does the local government regulate the hours or conduct of massage businesses? The Act has its own closing-hour rule, which Chapter 13 covers, and a local ordinance may add rules that are consistent with it.

Home occupations. If you plan to work from a residence, ask whether the local rules allow business use of a home, and what conditions apply. Remember that the Act requires an establishment license for a home practice, in addition to any local approval.

Ask in writing and keep the answer. Local staff can make mistakes or give informal answers that change. Ask for the answer by email or letter, and keep a copy. If the answer is complicated, a short consultation with a local attorney who handles land use may be well worth the cost.

Do not assume that no answer means yes. If a local office does not respond, follow up. Do not open until you know what the local rules require.

11.13 Common location mistakes and how to avoid them

Most violations related to location come from a short list of mistakes. Knowing them helps a therapist to avoid them.

Assuming a license travels with the person. A therapist's license permits her to practice, but only in a lawful setting. Moving from an employer to a home studio without a license for the studio is a violation.

Treating a client's friend's home as the client's residence. The exception speaks of the client's residence. A session at a place that belongs to someone else does not fit.

Offering colonic irrigation outside an establishment. The exceptions exclude colonic irrigation entirely. A therapist who offers it "at your home" is outside the law.

Starting event work on a verbal yes. The rule requires property manager of the site or the organizer of an event.">written approval. A verbal yes from a vendor or staff member leaves the therapist without proof and without compliance.

Forgetting the address update. A move, a job change or a change in the mix of settings requires notice. Failing to notify is a violation, and mail sent to the old address still counts as notice.

Ignoring local rules. Compliance with state licensing does not satisfy zoning, business registration or building codes.

Assuming a physician's office is a free-for-all. The exception requires a licensed therapist, the practitioner's own patients and the practitioner's place of practice. A therapist who treats walk-in clients at a clinic that is not employing her in that way may be outside the exception.

Not keeping records of approvals. Written approvals, address confirmations and local answers are evidence. Keep them in a folder.

11.14 A worked location audit

Rules are easier to remember when you apply them to a realistic plan. Consider a therapist, call her Alma, who is newly licensed and wants to build a practice. She has four ideas, and she decides to audit each against the decision guide before she spends any money.

Idea one: a treatment room in a hair salon she knows. Alma asks whether the salon room is a licensed massage establishment. It is not. The room is a portion of premises where she would practice, so it is an establishment, and it needs a license. She asks whether anyone holds one. The salon owner has never applied. Alma concludes that she cannot work there until a license is in place, and that the person who operates the establishment must hold it. She asks the owner whether she is willing to apply, and reads Chapter 12 to understand what that would involve.

Idea two: visiting clients at home. This matches the exception for the client's residence. Alma checks that each session will be at the client's own home, plans her safety routine, prepares a portable kit for assessment, consent and draping, and decides not to offer colonic irrigation. She reports her own residential address as her place of practice if she practices exclusively in the exception settings, and she keeps confirmation of the update.

Idea three: a chair massage table at a regional business expo. The setting is one of the listed events, but she has no approval. She finds the organizer's contact information, sends a short email asking for property manager of the site or the organizer of an event.">written approval, receives a reply with conditions about space and hours, saves it and follows the conditions. She prepares a brief intake for short sessions and keeps records out of sight.

Idea four: part-time work at a chiropractor's clinic. The chiropractor offers to employ her to treat the clinic's patients. Alma checks the three conditions. She is licensed, the patients are the chiropractor's own and the work is at the chiropractor's place of practice. She asks who owns the records under the contract, learns what written authorization is needed to share information among the clinic's providers, and reports the clinic's address as her place of practice for that work.

After the audit, Alma has a clear picture. One idea needs a license that does not exist, one is lawful with preparation, one needs written approval first, and one is lawful if the three conditions hold. She also has a folder of records: the event approval, the address confirmation and the notes of her questions. The audit took an afternoon, and it saved her from at least one violation.

The method is useful for any therapist. Write each idea, run it through the questions, note what you need and keep the answers.

11.15 Keeping a location file

Every therapist benefits from a simple file that documents where and under what authority she works. The file need not be elaborate. It serves as a quick reference when a question arises and as evidence if someone challenges your right to be in a place.

The file should hold the current establishment license or a note of the license number where you work, if you work in one, and the date you confirmed it. It should hold the written approvals for any event work, with the dates and conditions. It should hold the confirmation of each address update you made to the Department. It should hold any written answers you received from the Board, the Department or a local government about where you may practice. And it should hold a short note of your decisions, such as why you declined a particular request.

Review the file when anything changes: a move, a new employer, a new service, a new event. Update it before you begin work in a new place, not afterward. A file that is current takes minutes to review and can prevent days of trouble.

If you ever receive a complaint about where you practiced, the file will be among the first things you want. It shows that you checked, asked and acted in good faith, which a Board or a Department will want to see.

11.16 Frequently asked questions

May I work at a gym where I do not employ the owner but the gym lets me use a room? A gym is not on the list of exception settings. The room would need to be a licensed massage establishment, and local rules may also apply. Ask the Board and the gym's owner before you begin.

May I see a client at her workplace if her employer allows it? The exception covers the client's office. Confirm that the client has the authority to invite you and that the space is private and suitable. If the employer is the one hiring you to provide massage to employees, ask the Board how the arrangement is treated.

Does the event exception cover a private party at a client's home? A client's residence is a listed setting. If the party is at the client's own home and the client is the person receiving the service, the setting fits. If the service is offered to many guests, think about the practical and safety issues, and ask the Board if you are unsure how the rules apply to your arrangement.

May I share a room with a physician's office without being employed by the physician? The exception requires that the physician employ the therapist to treat the physician's patients at the physician's place of practice. A different arrangement does not fit, and you should ask the Board how it would be treated.

What if my landlord says I need no license? A landlord's opinion does not change the Act. The Act and the Board's rules govern. If you have a question, ask the Board or the Department in writing.

What if I travel to Florida for an event from another state? A therapist who is not licensed in Florida may not practice here. Chapter 7 explains endorsement, and Chapter 20 explains the penalties for unlicensed practice. Ask the Board before you plan an event.

Is my mailing address public? Ask the Department how it treats the address you provide. Whatever its policy, you remain responsible for keeping it current.

11.17 More scenarios to practice

Scenario F: The gym room. A therapist rents a small room at a gym to see her clients. The gym owner says, "It is my building, so I handle licensing." Is the arrangement lawful?

Discussion. A gym is not among the five exception settings, and the room is a site where a massage therapist practices, so it is an establishment. The room must be a licensed massage establishment, and the person who operates it must hold the license, as Chapter 12 explains. The owner's statement does not satisfy the Act unless an establishment license is actually in place. The therapist should ask to see the license before she works there.

Scenario G: The friend's house. A therapist's client asks her to come to a friend's house, where the client is staying for the weekend, for a session. Does the exception apply?

Discussion. The exception covers the client's residence and the client's office. A friend's house where the client is a guest is not obviously the client's residence, and the text reviewed for this course does not define the term. The safest course is to ask the Board in writing before relying on the exception, and to offer the client a session at her own home or at a licensed establishment instead.

Scenario H: The convention table. A therapist plans to offer chair massage at a convention. The organizer's website says to contact the exhibits manager. She calls and the manager says yes. What should she do next?

Discussion. She should ask for property manager of the site or the organizer of an event.">written approval, by email or letter, before she advertises or sets up. The rule requires written approval from the owner or property manager of the site or the organizer. A verbal yes from the manager is not written, and she would have no proof. She should save the reply, follow any conditions in it and bring a copy.

Scenario I: The clinic's walk-ins. A chiropractor hires a licensed massage therapist to treat the chiropractor's patients. The chiropractor also lets the therapist see clients from outside who call the clinic for massage only. Is that within the exception?

Discussion. The exception applies to the practitioner's patients at the practitioner's place of practice. A client who comes only for massage and is not the practitioner's patient does not fit the description. The arrangement for outside clients may require a massage establishment license for the space. The chiropractor and the therapist should ask the Board how to structure it.

Scenario J: The late notice. A therapist moved three months ago and did not update her address. A renewal notice and a notice about a complaint were sent to the old address. She learns of them when a friend mentions the complaint. What are her options?

Discussion. Mail to the last known mailing address the licensee has given to the Department.">address of record is adequate notice, so she cannot rely on not having received it. She should update her address at once, contact the Department about the complaint, ask what deadlines apply and consider consulting an attorney. She should expect that the failure to update her address may itself be a violation.

Chapter summary

The Act ties licensure to places as well as people. A therapist who practices at a site that is neither a licensed massage establishment nor a permitted exception violates the Act even if her own license is in good standing. Section 480.046(1)(o) makes practicing at an unlicensed site a ground for discipline, and section 480.047(1)(b) makes it unlawful to operate an unlicensed establishment, with a carve-out for teaching at a board-approved school. Because the definition of establishment includes a portion of premises, the rule reaches treatment rooms in other businesses and in a therapist's home.

Five settings are exceptions: the residence of a client, the office of a client, a sports event, a convention and a trade show. The list is closed, the first two are the client's places, and colonic irrigation is excluded from all five. Section 480.043(15) separately provides that a practitioner licensed under Chapter 457, 458, 459 or 460 who employs a licensed massage therapist to treat the practitioner's patients at the practitioner's place of practice need not hold a separate massage establishment license, except for the human trafficking reporting duty.

For events, Rule 64B7-23.011(12) makes it misconduct to offer massage without the property manager of the site or the organizer of an event.">written approval of the owner or property manager of the site or the organizer. Section 456.035 makes the licensee solely responsible for notifying the Department in writing of her current mailing address and place of practice, treats mail to the last address of record as adequate notice and allows discipline for failure to notify. Rule 64B7-23.001(11) allows the place of practice to be reported as the establishment, the practitioner's office or, for therapists who practice exclusively off-site under the exception, the therapist's residence.

Section 480.052 allows counties and municipalities to regulate licensed persons and establishments within their jurisdiction, as long as they do not exceed the state's powers or conflict with the Act. A therapist should check both state and local requirements before choosing a site.