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

For use if you are a Board Licensee and wish to change your public or home address, phone number, or other contact information. 

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

 

Non-Discrimination Policy

Non-Discrimination Policy

 

Arizona Ombudsman Office

The Ombudsman-Citizens Aide helps citizens to resolve ongoing issues with State Agencies

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 1,500 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. 

APPLYING ONLINE?  SCROLL DOWN FOR VERIFICATION AND OTHER FORMS

PLEASE ALLOW TWO (2) WEEKS FOR PROCESSING AND INTAKE OF YOUR APPLICATION BEFORE REQUESTING AN UPDATE OF THE STATUS.   IT TYPICALLY TAKES TWO TO THREE MONTHS FROM RECEIPT OF APPLICATION TO APPROVAL. A.A.C. R4-26-201 REQUIRES THAT AN APPLICATION BE PLACED ON AN AGENDA IF IT IS ADMINISTRATIVELY COMPLETE 18 DAYS PRIOR TO THE NEXT SCHEDULED BOARD MEETING. WE APPRECIATE YOU PLANNING ACCORDINGLY. 

 

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 Verification Forms: For Psychologist Applications. Form fillable PDFs. 

Core Program Requirements form (needed only if your doctoral program is NOT APA accredited.)

Supervised Preinternship Experience Log

Supervised Preinternship Experience Verification form

Supervised Psychology Internship or Training Experience Verification form

Postdoctoral Professional Psychology Experience Verification

Citizenship Status Form

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. Updated 01/2019 
 

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. 

Behavior Analyst Verification Forms - For Behavior Analyst Application for Licensure

Supervised Work Experience or Independent Fieldwork Verification
(Make as many copies as needed)

BCBA Certification Verification form
(follow instructions on the form to submit to BACB for verification that you passed the exam and are BCBA certified. A "Letter of Good Standing" is not required. BACB will email this completed form to the Board's office.)

Citizenship Status Form

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]. 

Forms

  • Application Forms
  • Renewal Forms
  • General Forms

Online Psychologist Applications and PSY & BA License Renewal Fees

ONLINE APPLICATION PORTAL: Click here to complete online Psychologist Applications and PSY or BA License Renewal Fees

PLEASE NOTE, WE ARE NOT ACCEPTING NEW ONLINE APPLICATIONS FOR BEHAVIOR ANALYSTS. IF YOU WISH TO APPLY FOR LICENSURE AS A BEHAVIOR ANALYST (BA), PLEASE DOWNLOAD THE PDF INITIAL APPLICATION FORM AND MAIL IT WITH YOUR PAYMENT TO THE BOARD OFFICE.

PLEASE CLICK ON "APPLICATION FORMS" BELOW TO DOWNLOAD THE BA INITIAL APPLICATION.

Please pay initial license fees by check or money order. Online payments for initial licensure for psychologists and behavior analysts are not accepted at this time. 

APPLICATION FORMS

RENEWAL FORMS

GENERAL FORMS

 

EFFECTIVE December 12, 2018

New Behavior Analyst Rules are now in effect. 

 Click here to go to the Statutes and Rules page. 

A new, revised Behavior Analyst application which conforms to the new Rules is now available on the Application Forms page. If the BA application form you are completing does not have a revision date of 12/2018, you will need to download the new application. Previous versions are not accepted after 12/11/2018.  

 

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

Electronic medium containing the name and address of each licensee
$0.05/name
Customized electronic medium 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

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Contact Us
Arizona Board of Psychologist Examiners
1740 W. Adams St, Ste. 3403
Phoenix, AZ 85007
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Phone: 602-542-8162
Fax: 602-542-8279
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