Official Government Website

Resources and Forms

FORMS

Intent To Sit For Exam

Application for Psychology License

Application for Duplicate

Conditional RX Supervised Hours Form

Criminal Conviction Disclosure Form

Evaluation and Accreditation of Supervised Internship

Evaluation and Accreditation of Supervised Practice

Evaluation of Supervised Experience form

Inquiry on Impact of Conviction Form

Interstate Mental or Behavioral Telehealth Registration

Name and Address Change Affidavit

Prescribing Psychologist Certification Application

Prescribing Psychologist Provisional Application

Request for Official License Certification form

Service Extender Application

Temporary Permit Application

LINKS and OTHER INFORMATION

The following list includes web page links or other information regarding professional, educational, and governmental entities that may be of interest.

Association of State and Provincial Psychology Boards (ASPPB)
P.O. Box 4389
Montgomery, AL 36103
Phone: (334) 832-4580
Fax: (334) 269-6379

www.asppb.net

American Psychological Association
750 First Street, NE
Washington, DC 20002
(202) 336-5500

Ethical Standards as adopted by Board Rule

Idaho Psychological Association
P.O. Box 1347
Eagle, ID 83616
(208) 454-5594

National Register of Health Service Providers in Psychology
1120 G Street, NW, Ste 330
Washington, DC 20005
Phone (202) 783-7663
Fax (202) 347-0550

PSYPACT – Psychology Interjurisdictional Compact
Phone (678) 216-1175
Email info@psypact.org

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