REGULATIONS
Vol. 39 Iss. 26 - August 14, 2023

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD FOR BARBERS AND COSMETOLOGY
Chapter 20
Forms

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Titles of Regulations: 18VAC41-20. Barbering and Cosmetology Regulations.

18VAC41-50. Tattooing Regulations.

18VAC41-60. Body-Piercing Regulations.

18VAC41-70. Esthetics Regulations.

Agency Contact: Tamika Rodriguez, Regulatory Operations Administrator, Department of Professional and Occupational Regulation, 9960 Mayland Drive, Suite 400, Richmond, VA 23233, telephone (804) 367-8590, FAX (866) 245-9693, or email barbercosmo@dpor.virginia.gov.

FORMS (18VAC41-20)

Barber – Barber Instructor Examination & License Application, A450-1301_02EXLIC-v14 (rev. 4/2019)

Master Barber Examination & License Application, A450-1301EXLIC-v16 (eff. 1/2021)

Nail Technician – Nail Technician Instructor Examination & License Application, A450-1206_07EXLIC-v17 (rev. 1/2021)

Wax Technician – Wax Technician Instructor Examination & License Application, A450-1214_15EXLIC-v16 (rev. 1/2021)

Cosmetology – Cosmetology Instructor Examination & License Application, A450-1201_04EXLIC-v19 (rev. 1/2021)

Temporary Permit Application, A450-1213TEMP-v2 (rev. 2/2017)

License by Endorsement Application, A450-1213END-v16 (rev. 1/2021)

Training & Experience Verification Form, A450-1213TREXP-v6 (eff. 2/2017)

Individuals – Reinstatement Application, A450-1213REI-v9 (rev. 2/2017)

Salon, Shop, Spa & Parlor License/Reinstatement Application A450-1213BUS-v9 (rev. 2/2017)

Barber - Master Barber - Barber Instructor Examination & License Application, A450-1301_EXLIC-v18 (rev. 5/2022)

Nail Technician – Nail Technician Instructor Examination & License Application, A450-1206_07EXLIC-v19 (rev. 5/2022)

Wax Technician – Wax Technician Instructor Examination & License Application, A450-1214_15EXLIC-v18 (rev. 5/2022)

Cosmetology – Cosmetology Instructor Examination & License Application, A450-1201_04EXLIC-v21 (rev. 5/2022)

Temporary Permit Application, A450-1213TEMP-v3 (rev. 12/2021)

License by Endorsement Application, A450-1213END-v18 (rev. 9/2022)

Individuals – Reinstatement Application, A450-1213REI-v13 (rev. 9/2022)

Salon, Shop, Spa & Parlor License/Reinstatement Application A450-1213BUS-v16 (rev. 9/2022)

Salon, Shop & Spa Self Inspection Form, A450-1213_SSS_INSP-v2 (eff. 5/2016)

Instructor Certification Application, A450-1213INST-v9 (rev. 1/2018)

Student Instructor – Temporary Permit Application A450-1213ST_TEMP-v2 (rev. 2/2017)

School License Application, A450-1213SCHL-v10 (rev. 2/2017)

School Reinstatement Application A450-1213SCHL-REIN-v3 (eff. 2/2017)

School Self-Inspection Form, A450-1213_SCH_INSP-v4 (eff. 5/2016)

Licensure Fee Notice, A450-1213FEE-v7 (rev. 1/2017)

Change of Responsible Management Application, A450-1213CRM-v1 (rev. 2/2017)

Training Substitution Form, A450-1213TR_SUB-v1 (rev. 1/2021)

Instructor Certification Application, A450-1213INST-v17 (rev. 10/2022)

Student Instructor – Temporary Permit Application A450-1213ST_TEMP-v4 (rev. 12/2021)

School License Application, A450-1213SCHL-v18 (rev. 5/2023)

School Reinstatement Application A450-1213SCHL-REIN-v9 (eff. 9/2022)

School Self-Inspection Form, A450-1213_SCH_INSP-v5 (eff. 1/2022)

Licensure Fee Notice, A450-1213FEE-v11 (rev. 9/2022)

Change of Responsible Management Application, A450-1213CRM-v6 (rev. 12/2021)

Training Substitution Form, A450-1213TR_SUB-v1 (rev. 10/2021)

Training Verification Form, A450-1213TR-vs1 (eff. 5/2022)

Experience Verification Form A450-1213EXP-v2 (eff. 7/2022)

Barber-Cosmetology Universal License App A450-1213ULR-v1 (eff. 7/2023)

FORMS (18VAC41-50)

Tattooer Examination & License Application, A425-1231EXLIC (eff. 9/2011)

Tattoo Training & Experience Verification Form, A425-12TATTREXP (eff. 9/2011)

Tattooing Apprenticeship Sponsor Application, A425-12TATSPON (eff. 9/2011)

Tattooer Apprenticeship Certification Application, A425-1234TAC (eff. 9/2011)

Tattoo Apprenticeship Completion Form, A425-12TAC (eff. 9/2011)

Tattoo Client Disclosure Form, A425-12DIS, A425-12TDIS (eff. 9/2011)

Limited Term Tattooer License Application, A450-1233LIC-v8 (rev. 9/2016)

Limited Term Tattoo Parlor License Application, A450-1235LIC-v5 (rev. 9/2016)

Permanent Cosmetic Tattooer Examination & License Application, A425-1236EXLIC (eff. 9/2011)

Master Permanent Cosmetic Tattooer Examination & License Application, A425-1237EXLIC (eff. 9/2011)

License by Endorsement Application, A450-1213END-v9 (rev. 9/2016)

Training & Experience Verification Form, A425-1213TREXP (eff. 9/2011)

Salon, Shop, Spa & Parlor License/Reinstatement Application, A450-1213BUS-v8 (rev. 9/2016)

Licensure Fee Notice, A450-1213FEE-v6 (rev. 9/2016)

Instructor Certification Application, A450-1213INST-v7 (rev. 9/2016)

Individuals - Reinstatement Application, A450-1213REI-v8 (rev. 9/2016)

School License Application, A450-1213SCHL-v9 (rev. 9/2016)

School Reinstatement Application, A450-1213SCHL-REIN-v2 (rev. 9/2016)

Tattooer Examination & License Application, A450-1231EXLIC-v16 (eff. 5/2022)

Training Verification Form, A450-1213TR-vs1 (eff. 5/2022)

Tattooing Apprenticeship Sponsor Application, A450-12TATSPON-v5 (eff. 7/2015)

Tattooer Apprenticeship Certification Application, A450-TAT_SOA-v2 (eff. 3/2015)

Tattoo Apprenticeship Completion Form, A450-12TAC-v8 (eff. 1/2020)

Tattoo Client Disclosure Form, A450-12TDIS-v3 (eff. 1/2020)

Limited Term Tattooer License Application, A450-1233LIC-v12 (rev. 9/2022)

Limited Term Tattoo Parlor License Application, A450-1235LIC-v9 (rev. 9/2022)

Permanent Cosmetic Tattooer Examination & License Application, A450-1236EXLIC-v15 (eff. 5/2022)

Master Permanent Cosmetic Tattooer Examination & License Application, A450-1237EXLIC-v13 (eff. 5/2022)

License by Endorsement Application, A450-1213END-v18 (rev. 9/2022)

Body Piercing, Tattoo, Perm Cos Tattoo Experience Verification Form, A450-12BPTATT_EXP-v2 (eff. 7/2022)

Body Piercing Salon/Tattooing Parlor License/Reinstatement Application, A450-12TATBP_BUS-v4 (rev. 9/2022)

Licensure Fee Notice, A450-1213FEE-v11 (rev. 9/2022)

Instructor Certification Application, A450-1213INST-vs17 (rev. 10/2022)

Individuals - Reinstatement Application, A450-1213REI-v13 (rev. 9/2022)

School License Application, A450-1213SCHL-v18 (rev. 5/2023)

School Reinstatement Application, A450-1213SCHL-REIN-v9 (rev. 9/2022)

Tattoo-Body Piercing Universal App A450-1231-41ULR-v1 (rev. 7/2023)

FORMS (18VAC41-60)

Body Piercer Examination & License Application, A425-1241EXLIC (eff. 9/2011)

Body-Piercing Training & Experience Verification Form, A425-12BPTREXP (eff. 9/2011)

Body-Piercing Apprenticeship Sponsor Application, A425-12BPSPON (eff. 9/2011)

Body-Piercing Apprentice Certification Application, A425-1244BPAC (eff. 9/2011)

Body-Piercing Apprenticeship Completion Form, A425-12BPAC (eff. 9/2011)

Body-Piercing Client Disclosure Form, A425-12BPDIS (eff. 9/2011)

Body Piercer Ear Only License Application, A450-1245LIC-v6 (rev. 9/2016)

License by Endorsement Application, A450-1213END-v9 (rev. 9/2016)

Training & Experience Verification Form, A425-1213TREXP (eff. 9/2011)

Salon, Shop, Spa & Parlor License/Reinstatement Application, A450-1213BUS-v8 (rev. 9/2016)

Licensure Fee Notice, A450-1213FEE-v6 (rev. 9/2016)

Individuals - Reinstatement Application, A450-1213REI-v8 (rev. 9/2016)

Body Piercer Examination & License Application, A450-1241EXLIC-v15 (eff. 5/2022)

Body-Piercing Apprenticeship Sponsor Application, A450-12BPSPON-v5 (eff. 7/2015)

Body-Piercing Apprentice Certification Application, A450-BP_SOA-v2 (eff. 3/2015)

Body-Piercing Apprenticeship Completion Form, A450-12BPAC-v8 (eff. 1/2020)

Body-Piercing Client Disclosure Form, A450-12BPDIS-v2 (eff. 4/2013)

Body Piercer Ear Only License Application, A450-1245LIC-v9 (rev. 9/2022)

License by Endorsement Application, A450-1213END-v18 (rev. 9/2022)

Body Piercing, Tattoo, Perm Cos Tattoo Experience Verification Form, A450-12BPTATT_EXP-v2 (eff. 7/2022)

Body Piercing Salon/Tattooing Parlor License/Reinstatement Application, A450-12TATBP_BUS-v84 (rev. 9/2022)

Licensure Fee Notice, A450-1213FEE-v11 (rev. 9/2022)

Individuals - Reinstatement Application, A450-1213REI-v13 (rev. 9/2022)

Tattoo-Body Piercing Universal App A450-1231-41ULR-v1 (rev. 7/2023)

FORMS (18VAC41-70)

Esthetician – Esthetics Instructor Examination & License Application, A450-1261_62EXLIC-v13 (eff. 1/2017)

Master Esthetician – Master Esthetics Instructor Examination & License Application, A450-1264_65EXLIC-v14 (eff. 1/2017)

Temporary Permit Application, A450-1213TEMP-v2 (eff. 1/2017)

License by Endorsement Application, A450-1213END-v10 (eff. 1/2017)

Training & Experience Verification Form, A450-1213TREXP-v5 (eff. 1/2017)

Individual - Reinstatement Application, A450-1213REI-v9 (eff. 1/2017)

Salon, Shop, Spa & Parlor License/Reinstatement Application A450-1213BUS-v9 (eff. 1/2017)

Salon, Shop & Spa Self Inspection Form, A450-1213_SSS_INSP-v3 (eff. 5/2016)

Instructor Certification Application, A450-1213INST-v8 (eff. 1/2017)

School License Application, A450-1213SCHL-v10 (eff. 1/2017)

School Reinstatement Application, A450-1213SCHL_REI-v3 (eff. 1/2017)

School Self Inspection Form, A450-1213SCH_INSP-v3 (eff. 5/2016)

Licensure Fee Notice, A450-1213FEE-v6 (rev. 9/2016)

Change of Responsible Management, A450-1213CRM (eff. 1/2017)

Esthetician – Esthetics Instructor Examination & License Application, A450-1261_62EXLIC-v17 (eff. 5/2022)

Master Esthetician – Master Esthetics Instructor Examination & License Application, A450-1264_65EXLIC-v18 (eff. 5/2022)

Temporary Permit Application, A450-1213TEMP-v3 (eff. 12/2021)

License by Endorsement Application, A450-1213END-v18 (eff. /2022)

Training Verification Form, A450-1213TR-vs1 (eff. 5/2022)

Individual - Reinstatement Application, A450-1213REI-v13 (eff. 9/2022)

Salon, Shop, Spa & Parlor License/Reinstatement Application A450-1213BUS-v16 (eff. 9/2022)

Salon, Shop & Spa Self Inspection Form, A450-1213_SSS_INSP-vs2 (eff. 5/2016)

Instructor Certification Application, A450-1213INST-v17 (eff. 10/2022)

School License Application, A450-1213SCHL-v18 (eff. 5/2023)

School Reinstatement Application, A450-1213SCHL_REI-v9 (eff. 9/2022)

School Self Inspection Form, A450-1213SCH_INSP-vs5 (eff. 1/2022)

Licensure Fee Notice, A450-1213FEE-v611 (rev. 2022)

Change of Responsible Management, A450-1213CRM-v6 (eff. 12/2021)

Experience Verification Form A450-1261_64EXP-v2 (eff. 2/2023)

Esthetics-Master Esthetics Universal License App A450-1261-65ULR-v1 (eff. 7/2023)

VA.R. Doc. No. R23-7603; Filed July 19, 2023