N.Y. Comp. Codes R. & Regs. tit. 8 § 72.5
A psychologist eligible for exempt practice in accordance with section 7605(8) of the Education Law, shall notify the department of the time and place of such exempt practice. Acceptable notification of the department shall be submitting the form prescribed by the department and payment of a $10 fee. The form shall identify the setting at which the psychologist will practice in New York State, which may include the use of distance technology acceptable to the department, and an affirmation that the psychologist shall comply with the laws, rules and regulations that define the practice of psychology in this State. Practice under this one-time exemption shall not exceed 10 consecutive business days or a total of 15 business days in a 90-day period.
N.Y. Comp. Codes R. & Regs. Tit. 8 § 72.5