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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. 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 application as PDF.

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Section 1: Program Application

Standard Certification Programs
Certified Massage Therapist (500 hrs)
Reflexology Certification (125 hrs)



Advanced Certification Programs*
Certified Massage Therapist (1000 hrs)

Specialization and Career Enhancement
 DOULA Training (50 hours)
Neuromuscular Rehabilitation Training (125 hrs)
Life Experience Program
Elective Classes/Continuing Education
Spa Therapy
Other


* These programs require specific previous experience and/or certifications. Please see each program's specific page or contact us for additional information.

Semester applying for:
Fall Winter/Spring Summer
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
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 :
 
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. Pregnancy and/or short-term disabilities may impede your progress in practicing and/or learning bodywork. So that we are able to assess any physical issues that could hinder you, please answer the following questions. 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 SCHOOLS OF MASSAGE is approved and regulated by the Colorado Division of Private Occupational Schools, Department of Higher Education.

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