Form - FORMS (18VAC125-20)

Current through Register Vol. 40, No. 22, June 17, 2024
Form - FORMS (18VAC125-20)

Application Instructions For Clinical Psychology (LCP), School Psychology, or Applied Psychology Licensure by Examination (rev. 4/2018)

Endorsement Application Instructions for Licensure as a Clinical, School, or Applied Psychologist (rev. 12/2018)

Application Instructions for Licensure as a School Psychologist-Limited (rev. 5/2018)

Employment Verification (rev. 5/2018)

Registration of Residency in Clinical or School Psychology (Post-Graduate Degree Supervised Experience) (rev. 5/2018)

Psychologist Application for Reinstatement of a Lapsed License (rev. 5/2018)

School Psychologist-Limited Application for Reinstatement of a Lapsed License (rev. 5/2018)

Psychologist/CSOTP Application for Reinstatement Following Disciplinary Action (rev. 5/2018)

Verification of Post-Degree Supervision (rev. 5/2018)

Internship Verification (rev. 5/2018)

Licensure/Certification Verification (rev. 5/2018)

Areas of Graduate Study (rev. 5/2018)

Continuing Education Summary Form (rev. 12/11)

Verification of Pre-Doctoral Supervised Practicum Hours (eff. 5/2018)

Verification of Post-Licensure Active Practice (rev. 8/2018)

Licensure Verification of Out-of-State Supervisor (rev. 5/2018)

Form for Reporting Psychology Grand Rounds Attendance (rev. 10/2011)

Continuing Education/Course Approval Request (rev. 4/2018)

Request for Board Approval of Evaluator (rev. 10/2017)

Request for Board Approval of Practice Supervisor (rev. 10/2017)

Request for Board Approval of Therapist (rev. 10/2017)

Psychology Name/Address Change Form (rev. 3/2016)

Request for Verification of Virginia Psychology License (rev. 7/2017)

Request for Change in Status of Virginia Clinical, School or Applied Psychologist License and School Psychologist Limited License (Current Active to Current Inactive) (rev. 5/2020)

Request for Change in Status of Virginia Psychology License (Current Inactive to Current Active) (rev. 5/2020)

Request for Change in Status of Virginia Psychology License (Current Inactive to Current Active at Annual Renewal Time) (rev. 5/2020)