Body arts temporary practitioner application - Contra Costa 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out your personal information in Section A. Enter your name as it appears on your Driver’s License or Federal Tax ID, along with your home address, phone number, and email address. Ensure the email can receive external messages.
3. In Section B, provide details about the facility or event where you will be practicing. Include the name of the event or school, event coordinator's contact information, and the complete address.
4. Complete Section C with the accounts receivable address if applicable. This should include a billing contact and their address.
5. Review all sections for completeness. Attach required documents such as your Bloodborne Pathogen Certificate, proof of Hepatitis B vaccination or declination form, and a copy of your photo ID.
6. Finally, sign and date the application at the bottom of Page 2 before submitting it through our platform.

Start using our platform today to easily fill out and submit your application for free!