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Alabama Massage Therapy — Requirements & Free Practice

US-AL · License preparation

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Massage Therapist License

Licensing authority: Alabama Massage Therapy Licensing Board · Application information

Initial licensure by endorsement
No examination is required for this applicant pathway.
Background Check
Submit fingerprint and criminal-history materials.
Education
Provide an official transcript; the Board may consider continuing education, experience, or other qualifications when schooling differs.
Fees
Pay applicable fees.
Hearing
The Board may require an initial in-person hearing.
Insurance
Show required liability coverage.
Lawful Presence
Document citizenship or lawful presence.
Prior License
Provide primary-source verification of another state massage therapist license or registration.
Standards
The other state’s original licensing standards must be at least as strict as Alabama’s.

Official no-examination sources

Effective from 2025-11-14.

Initial licensure by examination
Background Check
Complete fingerprint and criminal-history checks.
Education
Complete at least 650 hours of specified instruction and submit an official transcript.
Fees
Pay applicable fees.
Hearing
The Board may require an initial in-person hearing.
Insurance
Show at least $1 million professional and general liability coverage with an A-rated or better carrier.
Lawful Presence
Document citizenship or lawful presence.
Other State Exam
The Board may approve another state examination case by case.
Reinstatement after unnotified military deployment
Education
Complete missing hours within six months after return or discharge and do not reuse them next cycle.
Fees
Pay renewal fee; reinstatement and late penalties are waived.
Military Service
License was active when deployed but advance notice was not given.
Proof
Provide military orders or other service proof.
Timing
Apply while serving or within six months after discharge or return to inactive status.
Renewal during military deployment
No examination is required for this applicant pathway.
Education
Continuing education used here cannot be reused at next renewal.
Military Service
License was active at deployment and deployment proof was given to the Board in advance.
Timing
Renew by December 31 of the year following return.

Official no-examination sources

Effective from 2025-11-14.

Reinstatement of expired license
Background Check
Submit fingerprint and criminal-history material.
Education
Complete sixteen hours of continuing education.
Eligibility
License expired and practice ceased for no more than five years.
Fees
Pay reactivation and other applicable fees.
Insurance
Show required liability coverage.
Lawful Presence
Document citizenship or lawful presence if not previously established.
Biennial renewal
No examination is required for this applicant pathway.
Background Check
Complete a fingerprint background check if required at the first renewal after June 1, 2024.
Education
Complete sixteen hours of continuing education.
Fees
Pay renewal fees.
Insurance
Show required liability coverage.
Lawful Presence
Document citizenship or lawful presence if not previously established.
Timing
Renew by the anniversary date every two years.

Official no-examination sources

Effective from 2025-11-14.

Temporary Permit for Supervised Practice

Licensing authority: Alabama Massage Therapy Licensing Board · Application information

Temporary permit for supervised practice
Denial Grounds
Application materials must show no ground for denial.
Duration
Permit expires at 120 days, licensure, or denial, whichever is first; one permit per lifetime.
Initial Application
Be a first-time Alabama applicant and submit a complete initial licensure application.
Supervision
Practice only at the named licensed establishment while the named licensed massage therapist supervisor is present.

Massage & Bodywork Licensing Examination

Provider
Federation of State Massage Therapy Boards; administered at Pearson VUE (Pearson Professional Centers) test centers
Format
Computer-based, fixed-length computer-adaptive test (CAT) of multiple-choice questions, each with one correct answer; offered in English and Spanish and administered year-round; results reported as PASS or FAIL, with a diagnostic report by content area for failing candidates
Exam questions
100 multiple-choice questions
Time limit
110 minutes for 100 questions within a two-hour (120-minute) appointment
Passing score
Criterion-referenced passing standard adopted by the FSMTB Board of Directors; results reported as PASS or FAIL
Exam fee
$265 MBLEx application fee
Examination outline
  • Anatomy & Physiology (11%)
    • A. System structure — Cardiovascular
    • A. System structure — Digestive
    • A. System structure — Endocrine
    • A. System structure — Integumentary
    • A. System structure — Lymphatic & Immune
    • A. System structure — Musculoskeletal
    • A. System structure — Nervous
    • A. System structure — Reproduction
    • A. System structure — Respiratory
    • A. System structure — Sensory
    • A. System structure — Urinary
    • B. System function — Cardiovascular
    • B. System function — Digestion
    • B. System function — Endocrine
    • B. System function — Integumentary
    • B. System function — Lymphatic & Immune
    • B. System function — Musculoskeletal
    • B. System function — Nervous
    • B. System function — Reproduction
    • B. System function — Respiratory
    • B. System function — Sensory
    • B. System function — Urinary
    • C. Tissue injury and repair
    • D. Concepts of energetic anatomy
  • Kinesiology (12%)
    • A. Skeletal muscle components & characteristics
    • B. Concepts of skeletal muscle contractions
    • C. Proprioceptors
    • D. Skeletal muscle locations, attachments (origins, insertions), & actions
    • E. Joint structure and function
    • F. Range of motion — Active
    • F. Range of motion — Passive
    • F. Range of motion — Resisted
  • Pathology, Contraindications, Areas of Caution, Special Populations (14%)
    • A. Overview of Pathologies
    • B. Contraindications — Site specific
    • B. Contraindications — Pathology related
    • B. Contraindications — Special populations
    • B. Contraindications — Tools
    • B. Contraindications — Special applications
    • C. Areas of caution
    • D. Special populations
    • E. Classes of medications
  • Benefits and Effects of Soft Tissue Manipulation (15%)
    • A. Physiological effects of soft tissue manipulation
    • B. Psychological effects of soft tissue manipulation
    • C. Effects of soft tissue manipulation for specific client populations
    • D. Soft tissue techniques — Types of strokes
    • D. Soft tissue techniques — Sequence of application
    • E. Hot/cold applications
    • F. Overview of massage/bodywork modalities
  • Client Assessment, Reassessment & Treatment Planning (17%)
    • A. Organization of a massage/bodywork session
    • B. Client consultation and evaluation — Verbal intake
    • B. Client consultation and evaluation — Health history form
    • C. Written data collection
    • D. Visual assessment — General
    • D. Visual assessment — Postural
    • D. Visual assessment — Gait
    • E. Palpation assessment
    • F. Range of motion assessment
    • G. Clinical reasoning — Ability to rule out contraindications
    • G. Clinical reasoning — Client treatment goal setting
    • G. Clinical reasoning — Evaluation of response to previous treatment
    • G. Clinical reasoning — Formulation of treatment strategy
  • Ethics, Boundaries, Laws, Regulations (16%)
    • A. Ethical behavior
    • B. Professional boundaries
    • C. Code of ethics violations
    • D. The therapeutic relationship
    • E. Dual relationships
    • F. Sexual misconduct
    • G. Massage/bodywork-related laws and regulations
    • H. Scope of practice
    • I. Professional communication
    • J. Confidentiality
    • K. Principles
  • Guidelines for Professional Practice (15%)
    • A. Proper and safe use of equipment and supplies
    • B. Practitioner hygiene
    • C. Sanitation and cleanliness
    • D. Safety practices — Facilities
    • D. Safety practices — Practitioner safety
    • D. Safety practices — Client safety
    • E. Practitioner care — Body mechanics
    • E. Practitioner care — Personal protective equipment (PPE)
    • E. Practitioner care — Self-care
    • E. Practitioner care — Injury prevention
    • F. Draping — Safe and appropriate
    • F. Draping — Communication
    • G. Business Practices — Business planning
    • G. Business Practices — Strategic planning
    • G. Business Practices — Office management
    • G. Business Practices — Marketing
    • G. Business Practices — Hiring/Interviewing
    • G. Business Practices — Documentation & Records — Client records
    • G. Business Practices — Documentation & Records — Business records
    • H. Healthcare and business terminology
Examination sources

Board Certification Examination for Therapeutic Massage and Bodywork

Provider
National Certification Board for Therapeutic Massage & Bodywork; developed, administered and scored with Prometric at Prometric test centers
Format
Computer-based multiple-choice certification examination; four choices per question with one correct answer; results communicated on screen at completion as Pass or No Pass
Exam questions
140 multiple-choice questions
Time limit
140 minutes
Passing score
Scale score; each question graded right or wrong with no partial credit; reported as Pass or No Pass
Exam fee
$275 Board Certification Examination Fee
Examination outline
  • Assessment, Care Planning, and Documentation (25%)
    • Knowledge — Interview techniques (e.g., open-ended and fact-finding questions, verbal and nonverbal communication skills, reflective listening)
    • Knowledge — Assessment methods (e.g., health history, observation, palpation, range of motion, posture, gait, pain scale, special tests)
    • Knowledge — Common pathologies, injuries, and pre-/post-surgical considerations
    • Knowledge — Common prescription and non-prescription medications, their effects, and side effects (e.g., pain medications, muscle relaxants, cardiovascular agents, anti-inflammatories)
    • Knowledge — Stages of tissue healing
    • Knowledge — Special populations (e.g., pregnancy, oncology, geriatric, athletes, disabilities, palliative)
    • Knowledge — Indications and contraindications
    • Knowledge — How to customize a massage (e.g., analysis, synthesis, application of client information, and research data)
    • Knowledge — How to communicate with clients in understandable terms
    • Knowledge — Informed consent (e.g., risks and benefits)
    • Knowledge — Documentation formats (e.g., Subjective, Objective, Assessment/Application, Plan [SOAP], Focus, Data, Action, Response [FDAR])
    • Knowledge — Medically accepted terminology
    • Knowledge — Health care practices (e.g., prescription for treatment, medical insurance, procedural codes)
    • Skills — Use a variety of interview techniques to gather client information
    • Skills — Conduct a variety of assessments (e.g., range of motion, posture, gait, pain scale, palpation)
    • Skills — Develop a plan for the massage session (e.g., short-term, long-term where appropriate)
    • Skills — Identify and discuss indications, contraindications, pathologies, and special accommodations, and adapt the session as needed
    • Skills — Obtain informed consent
    • Skills — Adapt massage for pre- and post-surgical considerations
    • Skills — Adapt massage based on prescription and non-prescription medications
    • Skills — Customize massage based on client's goals
    • Skills — Monitor client responses, and solicit feedback during and after the session
    • Skills — Educate client about the care plan, including self-care activities as appropriate
    • Skills — Maintain client documentation
    • Skills — Utilize medically accepted terminology in client documentation
    • Skills — Collaborate with health care providers when appropriate
    • Skills — Apply research evidence to client-centered care planning
  • Massage Techniques and Modalities (24%)
    • Knowledge — General massage techniques (e.g., effleurage, petrissage, tapotement, vibration, friction)
    • Knowledge — Massage modalities (e.g., Swedish, deep tissue, neuromuscular/trigger point therapy, proprioceptive neuromuscular facilitation [PNF], Eastern and energetic bodywork therapies)
    • Knowledge — Pressure and manual forces (e.g., compression, tension/decompression, friction/shear, bending, torsion, vibration)
    • Knowledge — Stretching (e.g., barriers, end-feel)
    • Knowledge — Joint mobilization
    • Knowledge — Endangerment sites and adverse events
    • Knowledge — Client positioning (e.g., prone, supine, bolstered, side-lying, seated)
    • Knowledge — Appropriate use of tools and equipment
    • Knowledge — Appropriate use of topical agents (e.g., analgesics, essential oils, CBD)
    • Knowledge — Benefits and effects of techniques and modalities
    • Knowledge — Draping techniques
    • Skills — Apply massage and bodywork techniques in a safe manner, monitoring responses and adapting techniques as needed
    • Skills — Utilize effective body mechanics during the session
    • Skills — Identify the benefits of massage and bodywork techniques and modalities
    • Skills — Identify endangerment sites and adverse effects
    • Skills — Position clients for comfort and safety, utilizing positioning equipment as appropriate
    • Skills — Apply appropriate draping techniques
  • Anatomy, Physiology, and Kinesiology (24%)
    • Knowledge — Anatomy and physiology of all body systems, including: Integumentary system; Muscular system; Skeletal system; Nervous system; Cardiovascular system; Lymphatic system; Endocrine system; Reproductive system; Respiratory system; Digestive system; Urinary system
    • Knowledge — Immune response (e.g., inflammation, lethargy)
    • Knowledge — Kinesiology (e.g., mechanics of body movement including levers, agonists, antagonists, synergists, compensatory patterns)
    • Skills — Identify structures, functions, and interactions of body systems (i.e., integumentary, muscular, skeletal, nervous, cardiovascular, lymphatic, endocrine, reproductive, respiratory, digestive, urinary)
    • Skills — Identify origins, insertions, actions, functions, and innervations of muscles
    • Skills — Identify types of muscle contractions
  • Professional Practice (14%)
    • Knowledge — NCBTMB’s Standards of Practice
    • Knowledge — Standard of care for safe practice procedures (e.g., infection control)
    • Knowledge — Information literacy and research literacy (i.e., how to locate and evaluate research)
    • Knowledge — Professional development (e.g., continuing education, specialty credentials, board certification)
    • Knowledge — Therapist self-care (e.g., body mechanics, physical activity, hand-held tools, professional consultation, mentorships)
    • Knowledge — Business entities (e.g., independent contractor, employee, business structure)
    • Knowledge — Business practices and policies (e.g., marketing, cancellation, no-show)
    • Knowledge — Accounting principles and financial record keeping (e.g., tax filings, profit and loss, income reporting, bartering)
    • Knowledge — Professional liability insurance
    • Knowledge — Emergency preparedness (e.g., medical emergencies, disaster preparedness)
    • Skills — Maintain a clean, sanitary, safe, and accessible facility
    • Skills — Clean, disinfect, and maintain tools and equipment
    • Skills — Stay current with massage therapy research
    • Skills — Participate in professional development
    • Skills — Apply standard massage therapy business and employment practices
    • Skills — Practice self-care regimen for injury prevention and career longevity
    • Skills — Manage medical emergencies when they arise
  • Law and Ethics (13%)
    • Knowledge — Massage practice laws and regulations (e.g., licensing, scope of practice, insurance requirements)
    • Knowledge — Legal requirements for record keeping (e.g., retention, release, disposal, HIPAA)
    • Knowledge — Establishment laws and zoning ordinances
    • Knowledge — Ethical principles (e.g., confidentiality, autonomy, veracity, non-malfeasance, beneficence, nondiscrimination, empathy)
    • Knowledge — Professional roles and boundaries (e.g., dual relationships, power differential, transference and countertransference)
    • Knowledge — Ethical strategies for managing and resolving conflict (e.g., conflicts of interest, how and when to terminate a session, right of refusal)
    • Knowledge — NCBTMB’s Code of Ethics
    • Knowledge — Cultural sensitivity
    • Knowledge — When, where, and how to report inappropriate behavior and sexual misconduct (e.g., clients, peers)
    • Knowledge — Mandatory reporting requirements (e.g., human trafficking, minors and dependent adults)
    • Skills — Follow local and state laws and regulations for massage therapy practice, operating within scope of practice
    • Skills — Maintain client information and records, safeguarding client confidentiality
    • Skills — Apply ethical principles in professional interactions
    • Skills — Establish and maintain professional, culturally sensitive relationships with clients
    • Skills — Identify and manage legal and ethical conflicts
    • Skills — Establish, communicate, and respect therapist/client roles and boundaries
    • Skills — Report inappropriate behavior and sexual misconduct to the proper authorities
Examination sources