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Apply at the Healing Arts Institute

Take the first steps in starting your career at the Healing Arts Institute by enrolling securely online now!

Fill out the application form below to start you on your way towards a career in the Healing Arts profession. Note: * Asterisk indicates required data.

If you have any questions about this application -- or anything else regarding this web site or our school please contact us via e-mail at any time, or by phone during normal business hours. If you do not feel comfortable sending your application via e-mail, you may also download the Massage Program application as PDF. Or download application for any other Program as PDF.

Your application is encrypted between our server and your browser through industry standard SSL technology. In addition, once submitted, your application is encrypted using PGP technology.

Section 1: Program Application - Select at least one

Massage Therapy Program
Massage Therapy (600 hrs)

The Healing Arts Institute is accredited by the Accrediting Bureau of Health Education Schools, (ABHES).

Programs for the Public
Reflexology Program (125 hrs)

Advanced Programs
Neuromuscular Rehabilitation Training* (125 hrs)
* This program requires previous training.

Elective Classes
Spa Therapy
Other Elective Classes

The above programs are approved by the Colorado Division of Occupational Schools. Not approved by ABHES.

* Semester applying for:

Spring

Summer

Fall

* Year applying for:

* Day or Evening Class Sessions:

Days

Evenings

Section 2: Personal Information

* First Name:	Middle Initial:
* Last Name:
* Address:
* City:	* State:
* Zip/Postal Code:
* Phone (Daytime):
Phone (Evening):

* E-Mail:

* Date of Birth (e.g. 05/15/56):	Month: Day: Year:
* Ethnic Background (Check any that apply):	Hispanic/Latino African American Native Hawaiian / Pacific Islander Asian Caucasian Native American / Alaska Native

Section 3: Employment

* Currently Employed:	Yes No
If employed, fill in all employment data.
Current Employment:
Employer's Phone:
Place of Employment:

Section 4: Educational Background

	School Name	State	No Years/Hours	Area of Study	Certificate/Degree
High School/ GED:

College :

Trade/ Vocational :

Section 5: Emergency Contact

* Name:
* Address:
* Phone:
* Relationship:

Section 6: Personal Background Have you ever been convicted of a felony, or arrested for any sexual offenses? If so, please explain.
Yes No

Section 7: Health History

Practicing massage therapy requires physical stamina and flexibility. Practitioners are required to stand for long periods of time, have strong, flexible joints (wrists, elbows, ankles, and knees), and sit comfortably. We ask that you inform HAI of any physical issues you have that require special accommodations. Medical Conditions: (Please check all medical conditions occurring currently or within the last two years.)
Ankle/Foot Pain

Arm/Elbow Pain

Back Pain

Hip/Leg Pain

Shoulder Pain

Knee Pain

Neck Pain

Wrist/Hand Pain

Carpal Tunnel Syndrome

Sciatica

Skin Conditions

Other

Please describe any of the items you checked above:

To your knowledge, are there any medical, physical, mental or legal problems which either inhibit your effectiveness or preclude you from performing the duties of a massage practitioner or bodywork therapist? If so, please explain. Yes No

Please list any medications that you are currently using. (This includes prescriptions, herbal, and homeopathic formulas.)

Do you have a physical disability such as visual impairment, hearing impairment, etc. a learning disability such as ADD, ADHD, dyslexia; and/or a psychiatric disability (e.g., depression, bipolar, panic disorder, etc.) that could require special accommodations by HAI? Note: Information regarding disabilities is not requested for acceptance purposes. Yes No
If yes, please explain.

Section 8: Healing Arts Interests and Background

Do you have any previous experience in the fields of healing arts? Yes No

If so, please explain.

* How did you hear about us?

Internet
Newspaper
Word of mouth

Bus Shelters/Benches
Other

* What interests you in pursuing a massage and/or healing arts career?

* How do you plan to use the education you receive from us?

* Briefly describe your interests and how you would be an asset to HAI, and the field of massage and bodywork.

Have you ever attended a massage school in the past? Yes No

Name of School:
Address:
Attendance Dates:	From to
Why did you leave the school?

Agreement

Failure to disclose and/or falsified information may lead to dismissal from The Healing Arts Institute. I agree to follow all written school policies in the HAI catalogue and policies manual.

NOTE: By selecting the SUBMIT button, you are acknowledging your intent to enroll as a student at The Healing Arts Institute. You will be contacted by The Healing Arts Institute to complete your application process.

Until the application process is completed, you ARE NOT financially responsible for any school costs, fees or tuition payments.

HEALING ARTS INSTITUTE, FORT COLLINS SCHOOL OF MASSAGE is accredited by the Accrediting Bureau of Health Education Schools (ABHES) and is approved and regulated by the Colorado Division of Private Occupational Schools, Department of Higher Education.

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