Protecting the Public by Regulating the Professions of Psychology and Behavior Analysis

Application Forms

Psychologist Application for Exam and/or Licensure (includes Temporary Licensure)

Form for applicants who have conferred their doctoral degree, complete 1500 hours supervised internship experience and are seeking approval to take the Examination for Professional Practice in Psychology (EPPP). In addition, please use this form if your are already licensed in another state and wish to become licensed in Arizona.
FD ID-9 1/21/2012

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.
FD ID-10 1/21/2012

Behavior Analyst Application for Licensure

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

License/Certificate Verification Form

FD ID-49 2/6/2013

Pay Application and Initial License Fees

For use if you wish to submit online payment for an Application or Initial License fee (a convenience fee of $6.75 will be applied)

* If you are a Psychologist applicant Click Here
* If you are a Behavior Analyst applicant Click Here

Pay for Requested Records

For use if you wish to submit online payment for fees associated with any of the following (a convenience fee of $6.75 will be applied):

* Public records request

* Licensee directory request

* License Verification

* Other information/record requests for which there is an associated fee

Please note that you must have an invoice number from the Board office to use the payment portal for the above options. Contact the Board office at 602-542-8163 if you have questions.

* If your request is related to one or more psychologist(s) Click Here
* If your request is related to one or more behavior analyst(s) Click Here

Online License Renewals

For use if you are a Board licensee and wish to complete and pay for your license renewal on-line (a convenience fee of $6.75 will be applied)

* If you are a Psychologist Click Here
* If you are a Behavior Analyst Click Here

Fees

Application	$350
Reapplication	$200
Initial license (prorated)	$500
Duplicate license	$25
Biennial renewal of an active license	$500
Biennial renewal of an inactive license	$85
reinstatement of an active or inactive license	$200
Delinquent compliance with continuing education requirements	$200
Duplicate renewal receipt	$5
Statutes and rules	$5
Verification of a license	$2
Each audiotape of board meetings	$10
Computerized discs containing the name and address of each licensee	$0.05/name
Customized computerized discs containing the name and address of each licensee	$0.25/name
Copies of Board records, documents, letters, minutes, applications, files and policy statements	$0.25/page
Application for Temporary Licensure	$200

Application Forms

Footer Utility