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Instructions for EPPP & Licensure Application

Instructions for EPPP & Licensure Application

By selecting the application type, “EPPP & Licensure", you are seeking approval to sit for the EPPP, and approval for licensure upon a passing score (minimum 500 scaled score per A.R.S. § 32-2072).  
 

Requirements:

See A.R.S. § 32-2071 for details regarding requirements. Per Subsection D of this section, each applicant for licensure shall obtain 3,000 hours of supervised professional work experiences. The applicant shall obtain a minimum of 1,500 hours through an internship as described in subsection F of this section. The applicant shall obtain the remaining 1,500 hours through any combination of the following:

  1. Supervised preinternship professional experiences as described in subsection E of this section.
  2. Additional internship hours as described in subsection F of this section.
  3. Supervised postdoctoral experiences as described in subsection G of this section.
     

Applicant Must Submit:
 

  1. Completed online application and $350 application fee, paid online with submission of application.  Use the Applicant Portal to submit your application.  The Board no longer accepts applications from anyone other than the applicant. Third-party credentialers will no longer be apprised of the status of an application.  

Mandatory Uploads:
 

  1. Completed and signed Arizona Statement of Citizenship and Alien Status form (SOC) (All applicants must sign form on page 2, Section IV.)
  2. Current Government Issued ID:  Federal and state laws require applicants to provide proof of lawful status in the United States in order to receive a "public benefit" such as a professional license. Not all IDs are the same. See the Evidence List (page 3 of the SOC form) for accepted forms of ID. After uploading the SOC, please use the same upload button to upload a digital color photo of an appropriate ID per the evidence list. The upload must be high resolution, in color and readable.  Please note, if the documentation, such as a birth certificate, does not have your picture, you must also send a copy of a valid picture ID such as a driver’s license, US passport, military ID, etc.  
  3. Name Change Document (if applicable):  If any of your verifications such as transcripts, supervised professional experience (SPE) verifications, certifications, license verifications, etc. have a different name than the one on your ID, the legal document for the name change must also be submitted (e.g., court document, marriage license, etc.). Use the same upload button you used for the SOC and ID, if needed. 
  4. National Practitioner Data Bank Self-Query - Please provide a PDF copy of a new self-query from the National Practitioner Data Bank (NPDB). The processing date in the upper right corner of the self-query must within 30 days of your application submission date in order to be valid.  Upload the original PDF you download from the NPDB's website. Do not upload a copy or an image - the official document with digital signature from the NPDB is required.
  5. One original photograph taken not more than 60 days before the date of your application submission. This may be a photo taken with a digital camera or smartphone as long as it is high resolution, just head and shoulders like a photo on an ID, facing front, plain background, in focus, good lighting, etc. (“passport quality”).
  6. If you are applying preinternship and/or postdoctoral supervised professional experience (SPE) hours towards licensure, a copy of the signed and dated written training plan is required either from your DCT, supervisor or from you. The written training plan must meet requirements in A.A.C. R4-26-210(A) and/or (D). Most applicants upload the written training plan in their online application. If your preinternship (externship, practicum, etc.) or postdoctoral SPE did not require a written training plan, per the Board's substantive policy statements SP.01-10 (preinternships) and SP.01-14 (postdocs), the Board may consider a written post-experience training plan signed by the appropriate official - DCTs for preinternships and supervisors for postdocs. Applicants will need to work with the DCT or supervisor in crafting a post-experience training plan, and both the applicant and the DCT or supervisor must both sign it and list the date of signing. 

Optional Uploads:
 

  1. Core Program Requirements form: If the doctoral program from which you graduated was not accredited by APA or PCSAS, you must submit a completed Core Program Requirements form. You may list applicable graduate courses from a Master’s and/or Doctoral program to fulfill requirements in the content areas listed on the form. Undergraduate coursework is not acceptable. First read the instructions at the top of the form.  Accuracy is paramount. As part of substantive review, Application Review Committee (Committee or ARC) members compare the information submitted on this form with your official transcript(s). Historically the Committee has issued a Formal Additional Information Request (FAIR) if the form and transcripts do not match in every detail. A FAIR will add at least one month to the substantive review of your application. If the title of the course you list does not make it clear that it fits in the content area in which you placed it, you may wish to submit a course catalog or syllabi to support your choice for content area. Historically, if the Committee has a question about a course meeting requirements for that content area, a FAIR has been issued, adding at least one month to the substantive review of your application. Again, be accurate! 
  2. Documentation for YES answers to Declaration (professional conduct) questions, if applicable. See “Additional Documentation for YES Answers” for details regarding the documents required for your Yes answer(s). Your application will not be administratively complete without this appropriate documentation.


Applicant Must Cause to Be Sent by Verifier:  

Sent by email to [email protected] is preferable.

GO TO the FORMS page for specific instructions regarding each type of verification listed below, and to download a verification form as needed. 
 
  1. Official transcripts from all graduate institutions attended, regardless of degree, sent directly to the Board by the university/college  Transcripts sent electronically are preferred. These are sent most often by a school’s contracted third-party such as Parchment, National Student Clearinghouse, etc. Provide the email address, [email protected] for electronic delivery to the Board’s office.
  2. Verification of minimum 1,500 hours of Internship, which was completed within 24 consecutive months and meeting all other requirements for internships in A.R.S. Section 32-2071.  Please note, regardless of doctoral program or requirements in the state where the internship was completed, all requirements for internships delineated in this statute must be met for the internship to be approved for licensure in Arizona. There are no exceptions in statute or rule that allow the Board to accept an internship that is lacking in even one requirement.  Applicants must complete the top portion of the Internship Verification form and submit the form to their supervisor or current licensed psychologist who is the official custodian of records for the internship.  Download the Internship Verification form HERE.   The verifier must email the verification to [email protected]. (The psysubmissions email address is strictly for submissions. Questions should be emailed to the Board's licensing specialist at [email protected].) 
  3. Verification of Preinternship, if you are applying preinternship hours towards licensure (A.R.S. 32-2071(D)). Verifications must be submitted by the director of clinical training or similar official in order to be valid.  Applicants must complete Section A and B of the preinternshp form. The director of clinical training must verify Section B in Section C for each preinternship site, and then complete Sections D and E. The verifier must submit the completed and signed form directly to the Board's office.  Download the preinternship verification form HERE.  The verifier must email the verification to [email protected]. (The psysubmissions email address is strictly for submissions. Questions should be emailed to the Board's licensing specialist at [email protected].) 
  4. Verification of Postdoctoral Supervised Experience, if you are applying postdoctoral hours towards licensure. Applicants must complete the top portion of the Postdoctoral Verification form and submit it to their supervisor or current licensed psychologist who is the official custodian of records for the postdoc. Verification of one's supervised professional experience (SPE) hours needs to be for hours that are already completed.  An end date in the future is not possible because the hours haven't yet been completed. The hours and ratios required on the form must be finite, with a specific start and end date, even if you are still enrolled in a postdoc.  The dates should reflect the period of time in which the hours being verified were worked. Download the Postdoctoral Verification form HERE.  The verifier must email the verification to [email protected]. (The psysubmissions email address is strictly for submissions. Questions should be emailed to the Board's licensing specialist at [email protected].) 
  5. If applicable, verification of all psychology licenses and other professional licenses (may also be referred to as registrations or certifications) ever held in any states/provinces, sent directly to the Board of Psychologist Examiners by the issuing agency or board. This includes PSYPACT. All licenses ever held must be verified regardless of current status. Online verifications may be accepted ONLY IF the online license verification or license look-up states in writing that it may be considered primary source verification and the site’s disclaimer does not negate this statement. Provide the email address, [email protected],  for electronic delivery to the Board’s office.  If you become licensed in another state or province before your Arizona application is administratively complete, you must notify the Board of this change and have your new license verified to the Arizona Board. 
  6. Completed reference forms: The Board will contact these persons directly for the required information and endorsement on standardized forms provided by the Board.

  • To be acceptable, reference psychologists must be familiar with the applicant's work experience in the field of psychology or postdoctoral program within three (3) years immediately preceding the date of application.

  • If more than three (3) years have elapsed since the applicant last engaged in professional activities in the field of psychology or in a postdoctoral program, the references may be from the most recent three-year period in which the applicant engaged in professional activities in the field of psychology or in a postdoctoral program (R4-26-203(A)(26)).

  • If (b), above, the applicant must provide a written explanation of professional history since they last practiced in the field of psychology including dates.

  • Mere provision of a signature or an unfavorable report by a reference psychologist does not constitute provision of credentials necessary for licensure.

  • Reference psychologists shall be psychologists licensed or certified to practice psychology in a United States or Canadian jurisdiction. 

  • Members of the Arizona Board of Psychologist Examiners cannot provide references. 

  • The Board may reject any reference and/or require additional references from the applicant.

NOTICES

 

STATUTES AND RULES

Arizona licensees are expected to know the statutes and rules regulating the practice of Psychology in Arizona. You may download a free copy of the Statutes and Rules from the Board's website.

CONTACTING THE BOARD

Kathy Fowkes, Licensing Specialist
Email: [email protected]
Direct Line: (602) 542-8161
Fax: (602) 926-8095
Website: https://psychboard.az.gov 

Mailing Address
Arizona Board of Psychologist Examiners
1740 West Adams Street, Suite 3403
Phoenix, Arizona 85007

NOTICE FOR AMERICANS WITH DISABILITIES

Title II of the Americans with Disabilities Act (ADA) prohibits the Board from discriminating on the basis of disability in its public meetings. Persons with disabilities may request reasonable accommodations by contacting the Board at (602) 542-8162 to make their needs known. Requests should be made as soon as possible to allow time to arrange for accommodations. These documents may be made available in alternative formats by contacting the Board.

NOTICE

With respect to licensing decisions, please note that A.R.S. §41-1030 provides that:

B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition.
D. This section may be enforced in a private civil action and relief may be awarded against the state. The court may award reasonable attorney fees, damages and all fees associated with the license application to a party that prevails in an action against the state for a violation of this section.
E. A state employee may not intentionally or knowingly violate this section. A violation of this section is cause for disciplinary action or dismissal pursuant to the Agency's adopted personnel policy.
F. This section does not abrogate the immunity provided by section 12-820.01 or 12-820.02.

NOTICE

Pursuant to Section 41-1093.01, Arizona Revised Statutes, an agency shall limit all occupational regulations to regulations that are demonstrated to be necessary to specifically fulfill a public health, safety or welfare concern. Pursuant to Sections 41-1093.02 and 41-1093.03, Arizona Revised Statutes, you have the right to petition this agency to repeal or modify the occupational regulation or bring an action in a court of general jurisdiction to challenge the occupational regulation and to ensure compliance with Section 41-1093.01, Arizona Revised Statutes.