Dublin, CA · Alameda County
Application to Amend Massage Establishment Permit: Add, Remove, or Renew Employee
Massage establishment owners use this form to report employee additions or removals and submit massage therapist renewal or recertification applications.
What this form is
Dublin requires massage establishment owners to register employees with Dublin Police Services and promptly report employee changes using this form. Owners can add, remove, or renew employees and provide business and employee details, including names, positions, addresses, and CAMTC numbers. The form also lists required identification, photographs, and, for massage therapists, CAMTC documents; new therapists must also submit a Massage Therapist Registration form.
Who needs it
Owners of Dublin massage establishments use this form to report employee changes or submit a massage therapist’s CAMTC renewal or recertification application.
How to submit it
Submit the form to Dublin Police Services; the document lists 6361 Clark Avenue, Dublin, CA 94568, and [email protected]. It also lists the department’s phone number, 925-833-6670.
About notarization
This document is signed and dated without a notary; the owner certifies under penalty of perjury that the information is true and correct.
How to submit this form
- 1
Download The Form
Download the massage establishment employee update form.
- 2
Complete The Form
Enter the business information and list each employee to add, remove, or renew, including the requested employee details.
- 3
Gather Required Attachments
Include identification and photographs for all employees; add the listed CAMTC documents for massage therapists and registration for new therapists.
- 4
Sign And Date
The owner prints their name, signs, and dates the certification.
- 5
Submit To Dublin Police Services
Submit the completed form to Dublin Police Services using the contact details listed on the document.
Frequently asked questions
- Do I need a notary for the massage employee update form?
- No. The owner signs and dates the form without a notary, while certifying under penalty of perjury that the information is true and correct.
- Who uses the massage employee update form?
- Owners of massage establishments use it to report employee additions or removals and to submit CAMTC renewal or recertification applications for massage therapists.
- What attachments are required?
- For all employees, include a driver’s license or state ID copy and two current 2” x 2” color portrait photographs. For massage therapists, include a CAMTC ID card and certification; new therapists also need a Massage Therapist Registration form.
- How do I submit the massage employee update form?
- Submit it to Dublin Police Services. The form lists 6361 Clark Avenue, Dublin, CA 94568, and [email protected] as department contact details.
Need something notarized?
This Application to Amend Massage Establishment Permit: Add, Remove, or Renew Employee doesn’t need a notary — but if you have another Dublin form that does, a commissioned online notary can help.