LICENSE OR CERTIFICATE VERIFICATION FORM
If you are applying for licensure in Arizona, verification of other licenses/certifications you hold or may have held is required. Please use this form to obtain verification of licensure or certification from other jurisdictions in the United States and Canada in which you hold a license or certificate in psychology, behavior analysis, or any other type of license and/or certification.
Verifications of licensure/certification must be sent directly to the Board office via email, fax (with coversheet), mail or delivery service. Verifications may be submitted by email to [email protected].