Arizona Board of Psychologist Examiners
Protecting the Public by Regulating the Professions of Psychology and Behavior Analysis

Application Forms

 

PSYCHOLOGIST APPLICATION FOR EXAM AND/OR LICENSURE (includes Temporary Licensure)

Please use this Application Form if you fit into one or more of the following categories:

  • If you have had your doctoral degree conferred, completed 1500 hours supervised internship experience, and are seeking approval to take the Examination for Professional Practice in Psychology (EPPP), or
  • If you have completed the above, and in addition, have completed 1,500 hours of pre-internship and/or postdoctoral supervised experience(s) and are seeking approval to take the EPPP and obtain Licensure, or
  • If you have passed the EPPP and are seeking Licensure, or
  • If you are already licensed in another state and wish to become licensed in Arizona but are not credentialed by CPQ, ABPP, or NRHSPP, or
  • If you have had your doctoral degree conferred, completed 1,500 hours supervised internship experience, are enrolled in a postdoctoral supervised experience program and are seeking temporary licensure and/or approval to sit for the EPPP. 

 

Arizona Revised Statutes §41-1080.01 provides for a waiver of fees associated with initial licensure for qualified applicants. Applicants must have family income that does not exceed 200% of the Federal Poverty Guidelines. If you believe that you qualify for the waiver, please contact the Board office at 602-542-8163 to request the Application for Waiver of Initial Application Fee. 

PSYCHOLOGIST APPLICATION FOR LICENSURE BY CREDENTIAL

Form for psychologists who hold a: CPQ, NRHSPP, or ABPP credential, and who are licensed in good standing in another state or Canadian province for at least 5 years.
 

BEHAVIOR ANALYST APPLICATION FOR LICENSURE

Form for individuals applying for licensure as a behavior analyst.
FD ID-13 1/21/2012

Arizona Revised Statutes §41-1080.01 provides for a waiver of fees associated with initial licensure for qualified applicants. Applicants must have family income that does not exceed 200% of the Federal Poverty Guidelines. If you believe that you qualify for the waiver, please contact the Board office at 602-542-8163 to request the Application for Waiver of Initial Licensing Fees. 

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].