Application Forms

PSYCHOLOGIST APPLICATION FOR EXAM AND/OR LICENSURE (includes Supervised 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. 

All Online initial license applications have been disabled. Please use the form-fillable PDFs. Use Adobe Acrobat or Adobe Reader for best experience. All other programs and apps change the functions of the document. 

• PLEASE ALLOW UP TO THREE (3) WEEKS FOR PROCESSING AND INTAKE OF YOUR APPLICATION. 

• 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. ADMINISTRATVE COMPLETENESS ALSO INCLUDES THAT STAFF HAS TIME TO PROCESS THE APPLICATION. IF YOU ARE ATTEMPTING TO MEET AN ADMINISTRATIVE COMPLETENESS DEADLINE, SUBMIT YOUR APPLICATION EARLY ENOUGH FOR STAFF TO COMPLETE INTAKE OF YOUR APPLICATION.

• APPLICANTS MUST NOT EXPECT THEIR APPLICATIONS TO BE PLACED ON THE NEXT AGENDA IF THEIR APPLICATION IS NOT RECEIVED IN THE BOARD'S OFFICE IN A TIMELY MANNER. SENDING IT SO IT ARRIVES WITHIN 48 HOURS OF THE DEADLINE DOES NOT PROVIDE A REASONABLE AMOUNT OF TIME FOR STAFF TO REVIEW AND ASSESS ADMINISTRATIVE COMPLETENESS. 

• TIME FRAME FROM RECEIPT OF APPLICATION TO APPROVAL AVERAGES 3-4 MONTHS AND IS ENTIRELY DEPENDENT ON HOW QUICKLY VERIFICATIONS ARE RECEIVED.

APPLICATION FOR FEE WAIVER

Arizona Revised Statutes §41-1080.01 provides for a waiver of “any fee charged for an initial license for any individual or applicant whose family income does not exceed 200% of the Federal Poverty Guidelines if the individual is applying for that specific license in this state for the first time.” If you believe that you qualify for the waiver, please use the attached Application for Fee Waiver form.  Instructions are on the first page of the form. 

Psychologist Verification Forms: For Psychologist Application for Exam/Licensure or Temporary license: 

If you need a form and are unable to extract it from the application packet, please download and use the individual forms below, as applicable. The PDFs are form-fillable. Please use Adobe Acrobat or Adobe Reader for best experience.  Some fields will not be visible in your browser or via another program/app. 

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

Supervised Preinternship Experience Log (needed only if you are applying preinternship hours towards licensure)

Supervised Preinternship Experience Verification form (needed only if you are applying preinternship hours towards licensure. Must be submitted by your supervisor or director of training directly to the Board's office)

Supervised Psychology Internship or Training Experience Verification form (needed if you are applying via the Psychologist Application for Exam and/or Licensure form and have not been licensed for 20 years)

Postdoctoral Professional Psychology Experience Verification (needed only if you are applying postdoctoral hours towards licensure. Must be submitted by your supervisor directly to the Board's office)

Citizenship Status Form (all applicants are required to provide proof of lawful status in the United States)

Psychologist Application for Licensure by Universal Recognition

On August 27, 2019 the Arizona Board of Psychologist Examiners will begin accepting applications for licensure by universal recognition. 

Download the Psychologist Application for Licensure by Universal Recognition. 

This application is form-fillable. Please open in Adobe Acrobat or Adobe Reader for best experience and to see the digital signature blocks.

Please follow all instructions on the first page of the application packet. 

The universal recognition policy (A.R.S. § 32-4302) allows Arizona residents to use an out-of-state professional or occupational license to qualify for an Arizona license to work. To qualify, an applicant must:

• Prove residence in Arizona (See the Board's Substantive Policy Statement regarding this)
• Be currently licensed or certified for at least one year in another U.S. state or territory in the discipline applied for and at the same level of practice as recognized in Arizona.
• Be in good standing in all states where currently or previously licensed or certified. Verification is required directly from the licensing board to the AZ Board of Psychologist Examiners for all licenses or certifications ever held regardless of the status of the license or certification. Verifications ordered from other states may be emailed from the respective boards to [email protected]. 
• Have met all applicable education, work, exam, and/or clinical supervision requirements in the other state where originally licensed or certified. 
• Pay the $350 application fee by check or money order to the Arizona Board of Psychologist Examiners.