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Behavior Analyst Application for Licensure
Instructions and Downloadable Forms

Behavior Analyst Application for Licensure (including Reciprocity)

Arizona Revised Statutes (A.R.S.) § 32-2091.02, A.R.S. § 32-2091.03 and Arizona Administrative Code (A.A.C.) R4-26-203 through R4-26-406 establish licensure requirements. (see the Statutes and Rules page).

Both the general application for licensure as a behavior analyst (authorized under A.R.S. § 32-2091.02 & A.R.S. § 32-2091.03) and the reciprocity application (authorized under A.R.S. § 32-2091.04) are submitted using the same application - "Behavior Analyst Application for Licensure".  

  • If applicable, review the requirements to apply by reciprocity on the Board's Application Basics page.
  • Supervisors shall submit experience verification documentation to [email protected]
  • Applicants are not required to live in Arizona to apply for a license using this application.  
  • Applicants are not required to be licensed in another state to qualify for approval. However, all professional licenses regardless of status (e.g., active, inactive, expired, revoked, etc.) must be primary source verified. See the Section, "Primary Source Verifications" below for additional information. 
  • Checklist - Am I Ready to Submit My Application for Licensure? 
    • Please use this checklist to determine if you have completed all requirements for your license application as a Behavior Analyst. 
  • Are You Eligible for an Application Fee Waiver? 
    • Please go to this form to see eligibility requirements and to submit a request for a waiver of the application fee.  If you are applying for the fee waiver, DO NOT submit your application until you have received an email from the Board's office stating that you have been approved for the fee waiver. Per statute, application fees are non-refundable. 

Use the Applicant Portal to submit a behavior analyst application for licensure. You must use Chrome on a desktop or laptop computer, as other browsers and mobile devices are less compatible and may result in errors. 


Supporting documents and forms linked below may be downloaded for both the general and reciprocity pathways using the Behavior Analyst Application for Licensure. 


Download the individual forms as needed. The PDFs are form-fillable. Use Adobe Acrobat or Adobe Reader.  Do not use other apps or programs to complete the PDF forms.  Some fields will not be visible in your browser or via another program/app. Forms received in an altered format will be rejected. 



Use the Applicant Portal to submit the online application. Use the Chrome browser on a desktop or laptop computer. Other browsers and mobile devices are not compatible and may result in errors. 

The online application is self-explanatory.  However, as you complete the application, if you have questions, please email the Board's licensing specialist for behavior analysts, Zakiya ("Z") Mallas, at [email protected]

Have the following documents ready for upload to the online application. 

  • Statement of Citizenship or Alien Status Form (SOC):  All applicants are required to complete and submit this form. U.S. citizens must complete Sections I, II and IV.  Citizens of other countries must complete all four sections. This form needs to be uploaded to your online application where indicated.
  • Current Government Issued ID:  Federal and state laws require applicants to provide proof of lawful status in the United States in order to receive a "public benefit" such as a professional license. Not all IDs are the same. See the Evidence List (page 3 of the SOC form) for accepted forms of ID. After uploading the SOC, please use the same upload button to upload a color photo or PDF of an appropriate ID per the evidence list. The upload must be high resolution, in color and readable. 
  • Appropriate Documentation for "Yes" Answers
    • For Declaration (professional conduct) application questions, if your answer is "yes", additional documentation is required. See this PDF for a list of the associated documentation or evidence that the applicant must submit to the Board if the applicant’s answer to a question is “yes”.  Please note, your application will not be administratively complete until all associated documentation or evidence and a written detailed explanation addressed to the Board are received in the Board's office.  


Primary Source Verifications (PSVs)
  1. DO NOT submit PSVs with your application.  A PSV is not valid if submitted by an applicant. A PSV must be submitted by the verifier directly to the Board's office in order to be valid.  The verifier must email the verification to [email protected].  The submissions email address is monitored for document submissions only. (For questions, email Zakiya ("Z") at [email protected].)
  2. USE ADOBE ACROBAT OR ADOBE READER. For the downloadable PDFs below, using any other program or app is likely to result in errors, formatting changes and failure to see and be able to use the digital signature field.
  3. DO NOT use DocuSign! This popular app is extremely problematic; the font size of the verifier's answers are very, very small and difficult to read and the formatting of questions and answers usually becomes an unreadable mess. If a form is submitted with formatting changes or is unsigned, it will be rejected, causing unnecessary delays. 
  • Official Transcripts 
    • Official transcripts are required for all graduate coursework completed for a graduate degree program that met the requirements specified by the BACB at the time of graduation.
    • The official transcript must be received from the educational institution(s) directly to the Board's office at [email protected].
    • If a separate Verified Course Sequence (VCS) was completed, this transcript is also required.
    • If any coursework was completed during your undergrad years for which credit was accepted by your graduate degree program, the undergrad transcript must also be submitted by the educational institution. Otherwise, undergrad transcripts are not needed. 
    • Fulfillment by email is preferred. Most colleges and universities partner with, National Student Clearinghouse, or other third-party contractors to send electronic versions of official transcripts. 
    • If email is not an option, official transcripts may be mailed to the Board's office. See the Contact Us page for the mailing address. The Board is not responsible for lost mail. 
  • Supervised Work Experience or Fieldwork Verification
    • Applicants applying the same experience hours towards licensure which were used for BACB certification may supply this form to supervisors for completion and submission ([email protected]). Alternatively, the primary supervisor may submit a copy of the BACB Final Experience Verification form.
    • R4-26-403(C)(2) requires verifications be submitted directly from supervisors to the Board's office. Verifications submitted by applicants will not be accepted.
  • Supervised Experience Summary Form
    • Completion and submission of this Excel form with all associated documents is required for purposes of the Board determining whether an applicant's supervised experience meets Arizona's statutory and rule requirements under A.R.S. § 32-2091.03 and A.A.C. R4-26-404.2. It is the applicant's responsibility to submit all of the documents that are associated with each supervisor listed on the form. 
  • License Verifications
    • Verification of Licensure is required from every jurisdiction (U.S. state, district, territory or Canadian province) that has ever issued the applicant a license, registration and/or certification for any profession, regardless of current status (active, inactive, expired, revoked, surrendered, or otherwise). This does not include your BCBA certification. This is a national specialty certification and is not a license authorizing the practice of your profession. Verification of BCBA certification will be independently obtained by Board staff. 
    • A form is NOT provided for license verifications, which are PSVs.  Many boards, including Arizona's Board of Psychologist Examiners, no longer produce written PSVs of licensure separate from their online license lookups or licensee search pages. If any of your other licensing Boards have an online license lookup that states it is a "primary source verification", you may upload a screenshot or PDF of the online verification at the appropriate point in your application. If the primary source verification statement is on a separate page of that Board's website, please include a PDF or screenshot of this statement with the verification. (Use a Snip tool/app to take a screenshot, paste it into a Word document, repeat as needed if the PSV statement is on a separate web page, then print to PDF. ) No explanation is needed regarding this. Board staff is aware of this trend and knows to look for the primary source verification statement when these are uploaded. 
    • For PSV of licensure, the verification must state if there have been disciplinary actions taken against the license, or not.  If there are no actions, it is not enough to have nothing listed. There must be an unequivocal statement that there have been no actions. For this Board, the online verification states "Board Actions" and "None" or it will list details and a downloadable PDF copy of the action(s).  Every state has its own way to say it, but it must be included for it to be a PSV that meets requirements for a license application. 
    • If any of your other licensing Boards do not have the PSV statement on their online license lookups/licensee searches, or do not include a statement regarding the status of Board actions, applicants are responsible to contact their licensing Boards to request that verification of the license be sent to the Arizona Board. Each state has their own requirements for how to make this request. The applicant is responsible for any fees incurred. 
    • Make sure to include ALL U.S. states, districts and territories, as well as any Canadian provinces in which you hold or have ever held a license (certification, registration, etc.) regardless of current status of that license, in the applicable fields of the online application. Failure to do so is considered unprofessional conduct per A.R.S. § 32-2061(16) (and possibly other violations) and historically has resulted in denial of the application or disciplinary action against the Arizona license, up to and including revocation.