A. A license issued by the Board, whether active or inactive, expires on April 30 of every odd-numbered year unless renewed.
B. The Board considers a license renewal application packet timely submitted if delivered or mailed to the Board’s office and date stamped or postmarked on or before April 30 of the odd-numbered year in which the license expires.
C. To renew a license, a licensee shall submit to the Board a renewal application form, which is available from the Board office and on its website, signed and dated by the licensee, and provide the following:
1. Personal information about the applicant:
a. Full name;
b. Other names by which the applicant is or ever has been known;
c. License number;
d. Home address and telephone number;
e. Business name and address;
f. Work telephone and fax numbers;
g. E-mail address;
i. Date of birth;
j. Place of birth; and
k. Social Security number;
2. An indication of the address and telephone number to be listed in the Board’s public directory and used in correspondence;
3. An indication whether the applicant is active military;
4. A statement of whether the applicant:
a. Is in compliance with or exempt from the requirements of A.R.S. § 32-3211 regarding secure storage, transfer, and access to client or patient records and if not, explain;
b. Is currently licensed or certified as a psychologist in a regulatory jurisdiction other than Arizona and if so, the name of the regulatory jurisdiction and license number;
c. Is a licensed or certified member of another profession and if so, the name of the profession, regulatory jurisdiction, and license number;
d. Is a member of a hospital staff or provider panel and if so, the name of the hospital or panel;
e. Has completed the required 40 hours of continuing education and if not, an explanation of why the required hours have not been completed;
f. Has, during the last license period, been denied a license or certificate to practice any profession by any regulatory jurisdiction and if so, the name of the profession and regulatory jurisdiction and the reason for denial or a copy of the notice of denial;
g. Has, during the last license period, relinquished responsibilities, resigned a position, or been terminated while a complaint against the applicant was being investigated or adjudicated and if so, the dates and entity conducting the investigation or adjudication;
h. Has, during the last license period, resigned or been terminated from a professional organization, hospital staff, the military, or provider panel or surrendered a license while a complaint against the applicant was being investigated or adjudicated and if so, the dates and entity conducting the investigation or adjudication;
i. Has, during the last license period, been disciplined by an agency in any regulatory jurisdiction including the Arizona Board of Psychologist Examiners, the military, or a health care institution, provider panel, or ethics panel for acts pertaining to the applicant’s conduct as a psychologist or as a professional in any other field and if so, the name and address of the agency, nature and date of the disciplinary action, and statement of the charges and findings;
j. Is currently awaiting trial, has, during the last license period, been convicted of or pled no contest or guilty to any felony or a misdemeanor, other than a minor traffic offense (a DUI is not a minor traffic offense), or ever entered into a diversion program instead of prosecution, including any conviction that was expunged, deleted, or set aside in any state or country and if so, the convicting jurisdiction, offense, date of offense, status of resolution, expected resolution, a narrative explanation, and copies of relevant documents;
k. Is currently under investigation by any professional organization, the military, health care institution, or provider panel of which the applicant is a member or on staff, or regulatory agency concerning the ethical propriety or legality of the applicant’s conduct and if so, name of the entity involved and conduct at issue;
l. Has, during the last license period, been sued or prosecuted for an act or omission relating to the applicant’s practice as a psychologist, the applicant’s work under a license or certificate in another profession, or the applicant’s work as a member of a profession in which the applicant was not licensed or certified and if so, the name of the jurisdiction, allegation involved, date, and copies of relevant documents;
m. Is delinquent in payment of a judgment for child support and if so, the court that issued and date of the support order;
n. Has, during the last license period, had an application for membership in any professional organization rejected, or has had any professional organization suspend or revoke the applicant’s membership, place the applicant on probation, or otherwise censure the applicant for unethical or unprofessional conduct or other violation of eligibility or membership requirements and if so, name of the professional organization and date of the action;
o. Currently uses alcohol or another drug that in any way impairs or limits the applicant’s ability to practice psychology safely and competently;
p. Has a medical, physical, or psychological condition that may impair or limit the applicant’s ability to practice psychology safely and competently; and
q. Is submitting the renewal application timely and if not, whether the applicant has practiced psychology in Arizona since the license expired and if so, a complete explanation;
5. The license status for which application is made;
b. Inactive due to mental or physical disability,
c. Voluntary inactive,
d. Medical or inactive continuation, or
e. Retired. If retired status is requested, the applicant shall designate whether retired status is to be achieved by allowing the license to expire or requesting voluntary inactive status;
6. The following information about the continuing education completed during the previous license period:
a. Title of the continuing education;
b. Date completed;
c. Sponsoring organization, publication, or educational institution;
d. Number of hours in the continuing education; and
e. Brief description of the continuing education;
7. A signed attestation of the veracity of the information provided; and
8. Any other information authorized by statute.
D. Additionally, to renew a license, a licensee shall submit to the Board:
1. The license renewal fee required under R4-26-108;
2. If the documentation previously submitted under R4-26-203(B)(3) was a limited form of work authorization issued by the federal government, evidence that the work authorization has not expired; and
3. The Board’s Mandatory Confidential Information form.
E. If a completed application, including the information about continuing education completed, is timely submitted under subsections (C) and (D), the licensee may continue to practice psychology under the active license until notified by the Board that the application for renewal has been approved or denied. If the Board denies license renewal, the licensee may continue to practice psychology until the last day for seeking review of the Board’s decision or a later date fixed by a reviewing court.
F. Under A.R.S. § 32-2074(B), the license of a licensee who fails to submit a renewal application, including the information about continuing education completed, on or before April 30 of an odd-numbered year expires and the licensee shall immediately stop practicing psychology.
G. A psychologists whose license expires under subsection (F) may have the license reinstated by submitting the following to the Board on or before June 30 of the year in which the license expired:
1. The license renewal application required under subsection (C), including the information about continuing education completed, and the documents required under subsections (D)(2) and (3); and
2. The license renewal and reinstatement fees required under R4-26-108.
H. A psychologist whose license expires under subsection (F) and who fails to have the license reinstated under subsection (G) may have the license reinstated by:
1. Complying with subsections (G)(1) through (2) on or before the following April 30th, and
2. Paying the delinquent compliance fee in R4-26-108.
I. A psychologist whose license expires under subsection (F) and who fails to have the license reinstated under subsection (G) or (H) may be licensed again only by complying with R4-26-203.
J. If the Board audits the continuing education records of a licensee and determines that some of the hours do not conform to the standards listed in R4-26-207, the Board shall disallow the non-conforming hours. If the remaining hours are less than the number required, the Board shall deem the licensee as failing to satisfy the continuing education requirements and provide notice of the disallowance to the licensee. The licensee has 90 days from the mailing date of the Board’s notification of disallowance to complete the continuing education requirements for the past reporting period and shall provide the Board with an affidavit documenting completion. If the Board does not receive an affidavit within 90 days of the mailing date of notification of disallowance or the Board deems the affidavit insufficient, the Board may take disciplinary action under A.R.S. § 32-2081.