Form 28-23, Massage Technician Registration Application, is the City of Irvine form, headed Irvine Police Department Regulatory Affairs, that massage technicians complete to register for the first time or to renew a registration. The form tells independent contractors that an Irvine business license is also required and is renewed annually. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the application itself is submitted in person to the Regulatory Affairs Unit, as described below.
Last updated
What is 28-23?
Form 28-23, Massage Technician Registration Application, is the City of Irvine application used to register as a massage technician or to renew that registration. The printed form is headed Irvine Police Department, Regulatory Affairs.
The top of the form has two boxes, NEW and RENEWAL, under the heading Registration, plus an office-use line for the MASSAGE PERMIT#. The applicant section asks for personal identifiers, residential and mailing addresses, and up to two employers with the applicant's CAMTC MEMBER# (California Massage Therapy Council). A massage location section records whether you work as an employee of a massage establishment, as an independent contractor, in out-call, or in chair massage only.
At the end, the applicant signs a disclaimer. By signing, you state that you received and read City of Irvine Municipal Code §§ 2-10-301 through 2-10-319 and agree to comply with each section, and you certify under penalty of perjury that the information is true and correct.
The last block, FOR OFFICE USE ONLY, is completed by the city: it records whether the CAMTC certificate was verified, whether fees were paid, whether a business license applies, and who reviewed the application. The form is not a business license: it states that an independent contractor needs a business license in addition to the registration.
Who needs to file 28-23?
Massage technicians who need to register with the City of Irvine, or renew an existing registration, complete Form 28-23. You mark NEW for a first registration and RENEWAL for a renewal.
The form covers technicians in each working arrangement it lists:
- employees of a massage establishment;
- independent contractors;
- out-call technicians;
- technicians who do chair massage only.
If you are a massage technician and an independent contractor, the form states that a business license is also required and is renewed annually. That license is separate from this application.
Every applicant must also have a California Massage Therapy Council (CAMTC) certificate or ID card, because a copy goes with the application. If you work at a chiropractor's office, the form asks for the doctor's name in the massage location section. The form contains no provision for anyone to sign on the applicant's behalf: the applicant signs the certification personally.
When to file 28-23
Complete Form 28-23 when you apply to register as a massage technician in Irvine, or when you renew that registration. The form has separate NEW and RENEWAL boxes, and no separate due date is printed on it.
The Regulatory Affairs Unit processes a registration or renewal only when the items listed on the form are submitted in person together. Independent contractors have a second, recurring obligation: the business license the form requires for them is renewed annually. For the timing of a renewal or any processing time, call the Irvine Police Department, Regulatory Affairs Unit at 949-724-7218.
Documents you need
- A copy of your California Massage Therapy Council (CAMTC) certificate or ID card; the form lists it as a required item for every registration or renewal.
- A business license, only if you are a massage technician and an independent contractor; the form says it is also required and is renewed annually.
How to fill out 28-23
Mark new registration or renewal
At the top, check NEW for a first registration or RENEWAL if you are renewing. Leave the MASSAGE PERMIT# line for the city.
Enter your personal details
Under Applicant Information, enter last name, first name, middle initial, date of birth, sex, weight, height, eyes and hair. Add your driver's license number and state.
Enter identity and status
Enter your Social Security number and check YES or NO for U.S. citizen. If you are not a citizen, enter your resident alien number where the form asks.
Enter your residential address
Give your current address, the dates you resided there, city, state, ZIP and residential phone. Add a mailing address, mobile phone and alternate phone if they apply.
List your current employer
In Employment line 1, enter the employer name, occupation, CAMTC member number, address, dates of employment, city, state, ZIP and business phone.
List a second employer
If you have another employer, complete line 2 with the same details. The form provides two employer lines.
Choose your massage location type
Check one of Employee of Massage Establishment, Independent Contractor, Out-Call or Chair Massage Only. Enter the establishment name (a chiropractor's office needs the doctor's name), address, doctor's name and phone.
Read the disclaimer and sign
Read the two statements about City of Irvine Municipal Code §§ 2-10-301 through 2-10-319 and the penalty-of-perjury certification. Then sign and date the form yourself.
Leave office-use boxes blank
Do not fill in the FOR OFFICE USE ONLY section on page 2; the city records CAMTC verification, fees paid, any business license and review there.
Review, download and bring your documents
Check every entry against your CAMTC records, then download or print the completed PDF from FillingPDF. Bring it, with a copy of your CAMTC certificate or ID card, to the Regulatory Affairs Unit as described under How to submit.
How to submit 28-23
Form 28-23 is submitted in person to the Irvine Police Department, Regulatory Affairs Unit. The form's instructions say the items must be submitted IN PERSON, and it names no other channel.
Bring these items:
- The completed application: the Massage Technician Permit Registration Application form, signed and dated.
- Your CAMTC proof: a copy of your California Massage Therapy Council (CAMTC) certificate or ID card.
- A business license, if you are an independent contractor: the form says one is also required and is renewed annually.
The form prints no street address or office hours. For questions, call the Regulatory Affairs Unit at 949-724-7218. The office-use section of the form includes a line for fees paid, so ask the unit about any fee and how to pay it. FillingPDF lets you fill out and download the PDF; submission follows the in-person channel above.
Common mistakes to avoid
- Mailing or emailing the application when the form says the items must be submitted IN PERSON to the Regulatory Affairs Unit.
- Bringing the application without a copy of your CAMTC certificate or ID card.
- Working as an independent contractor without a business license, which the form says is also required and renewed annually.
- Signing the disclaimer without having read Municipal Code §§ 2-10-301 through 2-10-319, which the signature says you received and read.
- Leaving the application unsigned or undated; the certification is made under penalty of perjury.
- Working at a chiropractor's office and omitting the doctor's name, which the form requests under the establishment name and in the Doctor's Name box.
- Writing in the FOR OFFICE USE ONLY blocks, such as the massage permit number, CAMTC verification and fees paid; the city completes them.
Frequently asked questions
What is Form 28-23 used for in Irvine?
Form 28-23, the Massage Technician Registration Application, is used to register as a massage technician in the City of Irvine or to renew that registration. It is handled by the Irvine Police Department's Regulatory Affairs Unit and has separate NEW and RENEWAL boxes.
Do I need an Irvine business license as a massage technician?
If you are a massage technician and an independent contractor, yes: Form 28-23 says an Irvine business license is also required and is renewed annually. The form does not say that employees of a massage establishment need one.
Where do I submit the massage technician registration application?
In person to the Irvine Police Department, Regulatory Affairs Unit. The form says the items must be submitted IN PERSON and names no other channel. For questions, call the unit at 949-724-7218.
What do I bring with Form 28-23?
Bring the completed and signed application and a copy of your California Massage Therapy Council (CAMTC) certificate or ID card. Independent contractors also need a business license, which the form says is renewed annually.
Can I fill out Form 28-23 online?
You can complete the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the application with the city; you submit it in person to the Regulatory Affairs Unit.
What does my signature on the form mean?
You state that you received and read City of Irvine Municipal Code §§ 2-10-301 through 2-10-319 and agree to comply with each section. You also certify under penalty of perjury that the information on the application is true and correct.
Is there a fee for the massage technician registration?
The form's office-use section has a line for fees paid and an amount, so a fee may be collected by the city. The form prints no amount or payment method; ask the Regulatory Affairs Unit at 949-724-7218 before you go.
What do I enter if I work at a chiropractor's office?
In the massage location section, enter the chiropractor's name where the form asks for the name of the establishment, and also the doctor's name in the Doctor's Name box, along with the address and phone number.
Ready to fill out 28-23?
Fill out 28-23 now