PSY Applications

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Shortcuts to PDF Documents, Applications & Forms: 

Appropriate Documentation for "Yes" Answers to Professional Conduct Questions

Psychologist Application for Exam and/or Licensure
(This is also the application for a supervised temporary license)


Psychologist Application for Licensure by Credential


Psychologist Application for Licensure by Universal Recognition

This is the "reciprocity" application. 

  • Residence Determination - Board's  Substantive Policy Statement
  • Go to Arizona State Legislature's website to read the statute: A.R.S. § 32-4302. 
  • Application for Fee Waiver 
    If you are applying for a fee waiver, do not include the application fee with your application. Board staff cannot accept the application fee with the application for fee waiver. Under these circumstances, any checks or money orders will be returned.  You will be notified by Board staff in the event your application for fee waiver is not approved.

 

Psychologist Application for Exam and/or Licensure


Download the PDF Application:
Psychologist Application for Exam and/or Licensure

You do not have to live in Arizona to be licensed in Arizona with this application. 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 Parts 1 & 2), or
     
  • If you have completed the above, and in addition, have completed 1,500 hours of pre-internship and/or postdoctoral supervised experience(s) are not licensed in another state or Canadian province, and are seeking approval to take the EPPP (Part 1 and/or Part 2) and obtain Licensure in Arizona, or
     
  • If you have passed the EPPP (Parts 1 & 2) and are seeking Licensure in Arizona, or
     
  • If you have passed EPPP Part 1 and are already licensed in another state, you wish to become licensed in Arizona but do not hold a credential recognized by the Arizona Board (ABPP, CPQ or National Register) and do not qualify to be licensed by universal recognition, 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. 
     
  • PLEASE NOTE:  The temporary license (supervised) is issued under A.R.S. § 32-2073. The temporary license does not in any way or at any time transfer to an independent license. If in the future you wish to be licensed as an independent psychologist in Arizona, you will need to apply anew, pay the application fee and meet all requirements under A.R.S. § 32-2071. 
     

For professional conduct questions in this application, if the answer is "yes", appropriate documentation is required. Please see the PDF "Appropriate Documentation for "Yes" Answers" for a list of the associated documentation or evidence that the applicant must submit to the Board if the applicant’s answer to a professional conduct question is “yes”.

  • To pay the application fee:
    • Credit or Debit Card:  If paying by credit or debit card, please submit the application via the psychologist submissions portal. After your application has been entered into the Board's database, instructions will be sent by email.  Due to the backlog we are currently experiencing, please allow 30 days for processing. 
       
    • Check or Money Order: If paying the $350 application fee by check or money order, please mail your application with your payment to the Arizona Board of Psychologist Examiners. (Please make the check or money order out to the AZ Board of Psychologist Examiners.) It is recommended that a delivery service is used (i.e. FedEx, UPS, DHL, etc.) when sending checks or money orders. The Board is not responsible for lost mail. 


Application for Fee Waiver 

If you are applying for a fee waiver, do not include the application fee with your application. Board staff cannot accept the application fee with the application for fee waiver. Under these circumstances, any checks or money orders will be returned.  You will be notified by Board staff in the event your application for fee waiver is not approved.
 

Forms for Psychologist Application for Exam and/or Licensure
and for Temporary Licensure (Supervised) 

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 (Pages 12-13 of the application. Needed only if your doctoral program is NOT APA accredited.)

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

PREINTERNSHIP/PRACTICUM: Supervised Preinternship Experience Verification form  Needed only if you are applying preinternship hours towards licensure. Not needed if you have been licensed in another state for 10 years or more - you may waive the requirement to have additional hours verified. See page 4 of the application packet.  Not needed for temporary license application. Must be submitted by your supervisor or director of training directly to the Board's office. 

PREINTERNSHIP/PRACTICUM: Preinternship Verification form - Page 2 Needed if you are applying preinternship hours towards licensure and have multiple sites. Complete this page for each individual site. If you have 3 sites, there should be 3 copies of this page in the verification, one for each site.

INTERNSHIP: 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 been licensed less than 20 years. 

POSTDOC: Postdoctoral Professional Psychology Experience Verification  Needed only if you are applying postdoctoral hours towards licensure.  If you have been licensed in another state for 10 years or more, you do not need this form, because you may waive the requirement to have additional hours verified. See page 4 of the application packet. Not needed for temporary license application. Must be submitted by your supervisor directly to the Board's office.

Citizenship Status Form  All applicants are required to complete and submit this form, and provide proof of lawful status in the United States. See the evidence list on page 3 for accepted forms of ID. 

     

    Psychologist Application for Licensure by Credential

    Form for psychologists who hold a: CPQ (Certificate of Professional Qualification) NRHSP (National Register of Health Service Psychologists), or ABPP (American Board of Professional Psychology) credential, and who are licensed in good standing in another state or Canadian province for at least 5 years.  If you do not know what these credentials are, you likely do not hold one.  You do not have to live in Arizona to be licensed in Arizona with this application. The current application has a revision date of 11/2019.

    For questions 9 - 20 in this application, if the answer is "yes", appropriate documentation is required. Please see the PDF "Appropriate Documentation for "Yes" Answers" for a list of the associated documentation or evidence that the applicant must submit to the Board if the applicant’s answer to the question is “yes”.
     

    Download the PDF Application:
    Psychologist Application for Licensure by Credential

    • To pay the $350 application fee:
      • Credit or Debit Card:  If paying by credit or debit card, please submit the application via the psychologist submissions portal.  After your application has been entered into the Board's database, instructions will be sent by email.  Due to the backlog we are currently experiencing, please allow 30 days for processing. 
         
      • Check or Money Order: If paying the $350 application fee by check or money order, please mail your application with your payment to the Arizona Board of Psychologist Examiners. (Please make the check or money order out to the AZ Board of Psychologist Examiners.) It is recommended that a delivery service is used (i.e. FedEx, UPS, DHL, etc.) when sending checks or money orders. The Board is not responsible for lost mail. 
         

    Psychologist Application for Licensure by Universal Recognition

    On August 27, 2019 the Arizona Board of Psychologist Examiners began accepting applications 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. Follow all instructions on the first page of the application packet. 
     

    Download the PDF Application:
    Psychologist Application for Licensure by Universal Recognition 

    This is the "reciprocity" application. 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). You MUST establish residence in Arizona and be able to provide evidence of this. If you have not established residence in Arizona, or you answer NO to the statement, "I am a resident of Arizona", you DO NOT QUALIFY to apply for licensure using this application. If you have a recognized credential (ABPP, CPQ or National Register) and have been licensed for 5 or more years in another state, use the Credential application. Otherwise, use the standard app, Psychologist Application for Exam and/or Licensure. 
       
    • 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.
      • Credit or Debit Card:  If paying by credit or debit card, please submit the application via the psychologist submissions portal. After your application has been entered into the Board's database, instructions will be sent by email.  Due to the backlog we are currently experiencing, please allow 30 days for processing. 
         
      • Check or Money Order: If paying the $350 application fee by check or money order, please mail your application with your payment to the Arizona Board of Psychologist Examiners. (Please make the check or money order out to the AZ Board of Psychologist Examiners.) It is recommended that a delivery service is used (i.e. FedEx, UPS, DHL, etc.) when sending checks or money orders. The Board is not responsible for lost mail. 
         
    • For questions in this application, if the answer is "yes", appropriate documentation is required. Please see the PDF "Appropriate Documentation for "Yes" Answers" for a list of the associated documentation or evidence that the applicant must submit to the Board if the applicant’s answer to the question is “yes”.

     

    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 application below and submit with your initial license application.

    Download the PDF Application:
    Application for Fee Waiver

    • Instructions are on the first page of the form.
    • If you are applying for a fee waiver, do not include the application fee with your application. Board staff cannot accept the application fee with the application for fee waiver. Under these circumstances, any checks or money orders will be returned.  Board staff will email you regarding your fee waiver application once review is completed.

     

    Scroll down to see more information about the licensure process.

     

    Credit/Debit Card Payments for Application Fees

    Staff cannot process credit/debit cards. If you wish to pay your application fee online with a credit card, please submit your application first (email is acceptable) and let Board staff know you want to pay the fee via credit/debit card. Staff must enter your application in the system before the application fee can be paid via the online application portal. Otherwise,  initial application fees may be paid by check or money order via mail or delivery.


    What You Need to Know About the Application Process:

    • Time frame from receipt of application to approval averages 5-6 months and is entirely dependent on how quickly verifications are received. For example, if you wish to be licensed in July, please send your application in January. 
       
    • Applicants may request verifications or other documentation sent to the Board in advance of their application. Verifications, transcripts, and any other documents received in the Board's office (by email, mail, fax or delivery service) are retained for 12 months and are matched to the application once the application is received. Verifications for supervised hours should be uploaded by the verifier to the via the psychologist submissions portal. License verifications and official transcripts may be emailed to [email protected].) 
       
    • Due to the state of emergency, please allow up to six (6) weeks for staff to complete the initial intake of your application and email you a a notice of incomplete application (or administratively complete application if it is complete).  
       
    • We do not have an online application. All applicants must submit a form-fillable PDF application by email or mail. Use Adobe Acrobat or Adobe Reader for best experience when filling out an application. All other programs and apps change the functions of the document. Digital signatures are acceptable. To see the signature block, open the application in Acrobat or Reader.
       
    • Please note, if you answer "yes" to any professional conduct question, appropriate documentation is required. Please see the PDF, "Appropriate Documentation for 'Yes' Answers" for a list of documents the Board requires for each professional conduct question that may be found in the psychologist applications. Your application cannot be considered administratively complete without the appropriate documentation. 
       
    • 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. This also means that an application that is not administratively complete cannot be placed on an agenda. "Administrative completeness" means that all required verifications and documentation have been received and processed by Board staff.  Please be aware that staff has up to 100 applications open in various stages of completeness at any given time, and applications and documentation are processed in the order they are received.  If any item has not been received, you will receive a notice of deficiency and your application will be placed on the next available agenda AFTER the missing documentation is received. 
       
    • It is the responsibility of the applicant to request an update after the initial notice of deficiency has been emailed to the applicant by Board staff.  For updates regarding your application, please email the licensing specialist at [email protected].  It is up to the applicant to keep track of when documentation has been sent, and request an update regarding the Board's receipt of that documentation.  Please note, we are experiencing a backlog of applications and a high volume of emails.