Here is the compact answer: the overwhelming majority of states require some form of bloodborne pathogen training, but they attach it to very different systems. Some issue a state license, some regulate only the shop, and some hand the whole thing to county health departments. Below, you will find which states name BBP explicitly, which add first aid or CPR, and which build the strictest medical screening on top of it.

What is bloodborne pathogen training for tattoo artists?

Bloodborne pathogen training teaches Tattoo Artists how to prevent the transmission of infectious diseases through blood and body fluids, and it is the single most common credential across tattoo license requirements by state.

BBP training generally follows OSHA’s bloodborne pathogens standard, covering universal precautions, safe handling of sharps, single-use items, and proper waste disposal. Many states require you to renew this certification annually. In our verified data, states describe it as a “BBP course,” a “BBP certificate,” or “BBP training,” and several tie it directly to your license or shop registration.

Tattooing is an AI-proof, hands-on career, and a Professional Tattoo Artist can earn over $106,000 a year according to ZipRecruiter. Understanding BBP rules is one of the first professional steps toward that income.

Which states require BBP as part of a state license?

Many states issue an individual tattoo license and require bloodborne pathogen training as a condition of holding it.

In these states, the license is issued at the state level and BBP is baked into the requirements:

• Alaska (Board of Barbers and Hairdressers): requires a current bloodborne pathogens card, plus CPR and either 1,650 school hours or 2,000 tattoo apprenticeship hours.
• Arkansas (Department of Health): a 375-hour tattoo apprenticeship and state exam, with strict infectious disease prevention enforcement.
• Connecticut (Department of Public Health): 2,000 training hours, an approved BBP course, first aid, and a written exam.
• Florida (Department of Health, county-administered): a DOH-approved BBP and communicable diseases course scored 70% or higher, plus a $60 application fee.
• Georgia (Department of Public Health): a state Body Art Exam plus BBP, first aid, and CPR that cannot expire within 6 months of renewal.
• Iowa (DIAL): a valid BBP certificate and standard first aid, with a $75 artist permit and $100 establishment permit annually.
• Maine, Minnesota, Mississippi, Missouri, Nebraska, Rhode Island, South Carolina, Wisconsin, and others all list BBP as a required credential attached to a state-issued license.

Wisconsin is the cleanest example of centralization: a single “Practitioner’s License” costing $60 with proof of BBP training. Minnesota issues a “Body Art Technician” license requiring current BBP certification within the last year plus 200 logged, notarized tattoo hours.

Which states pair BBP with CPR or first aid?

Several states require CPR, first aid, or both in addition to bloodborne pathogen training.

Based on our verified facts, these states go beyond BBP alone:

• Tennessee requires both CPR and first aid certification for licensure, one of roughly 11 states noted for this dual requirement.
• Oregon requires CPR/first aid certification, BBP training, a state-approved 360-hour curriculum, and an HLO written exam.
• Connecticut requires an approved BBP course plus current basic first aid from the American Red Cross or AHA.
• Maine requires both BBP and first aid training.
• Iowa requires standard first aid and explicitly rejects a standalone CPR/AED certificate.
• Georgia requires BBP, first aid, and CPR together.
• Alaska requires a current CPR card alongside its bloodborne pathogens card.
• Ohio requires current BBP and first aid certification, with local health districts handling permits.
• Maryland lists BBP and first aid as industry standards even without a statewide license.

How do shop-only states handle BBP?

In shop-only states, the studio holds the license and BBP training is enforced through the establishment rather than an individual artist license.

These states place the regulatory burden on the shop, but BBP still applies to every artist:

• Illinois (IDPH): artists are registered within a registered facility and must complete annual BBP training.
• Indiana (IDOH): the operator ensures every artist completes annual OSHA-compliant BBP training and keeps records; counties like Marion and Johnson add permits.
• Louisiana (DHH): register through a licensed establishment and complete annual BBP training.
• Michigan (MDHHS): the shop must be licensed, and artists need current BBP certification renewed annually.
• North Dakota (HHS): practitioners register through a permitted establishment under OSHA BBP standards.
• Ohio (ODH): current BBP certification is enforced through local health district facility permits.

The takeaway for shop-only states is simple: even without a personal license, you cannot skip BBP. The owner is responsible for keeping every artist’s certification current.

What about county-run and local BBP rules?

In county-local states, bloodborne pathogen requirements are set and enforced at the county or city level, so the exact rule depends on where you work.

These states delegate execution to local health authorities:

• California: a Local Enforcement Agency in each county handles registration, and you need an LEA-approved BBP course certificate. LA County lists a $54 initial registration fee.
• Colorado: BBP certification plus annual permits in regulated counties like Denver, which expects aseptic-technique knowledge.
• Kentucky: annual BBP certification layered on top of a local health department permit and inspection.
• Massachusetts: a typical two-year tattoo apprenticeship, BBP certification, and a local sanitation exam through the town Board of Health.
• Nevada: a “Body Art Card” in Clark County and a similar permit in Washoe County, each requiring a sanitation exam and BBP certification.
• New York: NYC requires the Health Academy Infection Control Course and a written exam; counties outside the city vary widely.
• North Carolina: a county “Tattoo Permit” tied to a specific artist and shop, requiring BBP training. The permit is non-portable.
• New Jersey: OSHA-compliant BBP training is mandatory at all levels, with a Practitioner vs. Apprentice tier based on 2,000 hours.
• Montana, Pennsylvania, South Dakota, Utah, West Virginia, Wyoming: rules and fees are determined locally, so always confirm with the specific department.

Pennsylvania shows how much variation is possible: Philadelphia requires an apprenticeship letter from a certified artist and a $40 fee, while other counties may impose no health oversight at all.

Which states have minimal or no state BBP licensing?

A few states have no formal state licensing board, so bloodborne pathogen compliance falls to OSHA standards, local rules, or voluntary industry practice.

• Arizona: no state board, business registration only, with private BBP certification recommended for insurance and shop standards. Its statute focuses solely on protecting minors.
• Idaho: no state license; artists must work from a business location and follow OSHA bloodborne pathogen standards, with local health districts setting any additional rules.
• Maryland: no statewide license; BBP and first aid are industry standards, and counties like Montgomery add ordinances.

Delaware sits nearby with a state-permit model rather than an individual license, requiring a valid BBP certificate, a permitted establishment with a hazardous waste contract, and notarized consent for specific minor procedures. Alabama also uses a state-permit model administered through county health departments, requiring an approved BBP course within the prior 36 months and a hepatitis B vaccination or signed declination.

Which states go beyond BBP with extra medical screening?

Hawaii stands apart by requiring tuberculosis and syphilis medical reports on top of bloodborne pathogen certification.

Hawaii’s Department of Health Sanitation Branch requires BBP certification, TB and Syphilis medical reports, and a written exam, with licenses typically expiring at the end of even-numbered years. It is one of the only states in our data that requires this kind of personal medical screening.

Several states pair BBP with a hepatitis B vaccination or signed declination, including Alabama, California, and Georgia. This is a health protection for the artist rather than a screening requirement, but it is worth budgeting time for when you apply.

How we grouped this

We grouped states strictly by the licensing model and the credentials listed in our verified regulatory facts, not by opinion.

Our criteria were: the licensing model (state-license, state-permit, shop-only, county-local, or minimal), whether bloodborne pathogen training is explicitly named, and whether additional credentials such as CPR, first aid, or medical screening are listed. Fee mentions are pulled only from states that publish a figure inline, and we labeled each figure by what it actually is.

For reference, the inline fee figures in our data include Florida’s $60 application fee, Iowa’s $75 artist and $100 establishment permits, California’s $54 LA County registration, Washington’s $275 application fee and $330 shop license, Virginia’s $120 fee, New Mexico’s $100 initial licensure fee, Wisconsin’s $60 license, Pennsylvania’s $40 Philadelphia fee, and Texas’s $927 studio license. Oklahoma’s $100,000 figure is a formerly required surety bond that has since been removed, not a license fee. Every other state publishes fees on its official forms rather than inline, so we did not guess.