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Telehealth Registry

Telehealth Registry

Telehealth Registry - $600 (no renewal fee)

The Board is now accepting Telehealth Registry online applications for out-of-state licensed psychologists and behavior analysts who are not licensed in Arizona and wish to provide healthcare services via telehealth to a client located in Arizona.

This registration is for telehealth only, and is not a license. To apply, go to the Telehealth Registry site. This online application is shared with other boards and is not available through the Applicant Portal.   

If you hold an Arizona license, you do not need to be registered in the Telehealth Registry to practice via telehealth into Arizona. An Arizona license authorizes the licensee to practice their profession in Arizona in person or via telehealth. 

  • The Registry is authorized by Title 36, Chapter 36.   
  • This registration IS NOT a license! Registrants are prohibited from practicing in person in Arizona without a full, independent license.
  • Visit the online Telehealth Registry Application to apply.  The application fee is $600. 
  • The registration does not need to be renewed. However, annual reporting is required. Failure to timely submit the annual report may be grounds for disciplinary action up to and including revocation of the registration, reportable to the National Practitioner Data Bank. 
  • See A.R.S. § 36-3606 for detailed requirements. 

 

Mandatory Uploads with Application Submission

You may wish to prepare the following documentation, below, before starting the TR application. You will be required to upload these documents as part of the application submission process. 

  1. Evidence of possessing professional liability insurance coverage that includes coverage for telehealth services provided in
    Arizona.  Historically, in most instances, a Certificate of Liability Insurance that demonstrates current coverage and includes service provided via telehealth has been acceptable to the Board. 
  2. Evidence of having secured a duly appointed statutory agent for service of process in Arizona, signed and dated by the agent.  Your statutory agent may have a standard acceptance letter to give you, or you may have them complete the Board's Statutory Agent Appointment Affirmation form, downloadable HERE.  Note that the Board has stated that a receipt is NOT sufficient evidence of having secured a statutory agent for service of process in Arizona. 
  3. National Practitioner Data Bank (NPDB) self-query generated within 30 days prior to submission of the TR application.  Must be the PDF downloaded from https://npdb.hrsa.gov with the NPDB's verifiable digital signature. Copies are not acceptable. 
  4. A signed statement that you have read the Arizona Revised Statutes and the Arizona Administrative Code sections that govern the practice of psychology in Arizona. This signed statement may be combined on one page with the statement in #5, below. 
  5. A signed statement affirming you will annually update your registration with the Arizona Board of Psychologist Examiners and will submit to the Board a report with the number of patients served in Arizona and the total number and type of encounters in this state for the preceding year. This signed statement may be combined on one page with the statement in #4, above. 

 

Go to the Telehealth Registry site to apply online for Telehealth Registration