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App Checklist Form

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0% found this document useful (0 votes)
9 views

App Checklist Form

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Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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You are on page 1/ 3

LICENSING UNIT

APPLICATION FOR LICENSURE AS A PSYCHOLOGIST


INITIAL APPLICATION CHECKLIST

INTRODUCTION:
This checklist is to assist you in gathering the required documents for an Application for Licensure as a Psychologist
to obtain eligibility to take an examination as the frst step towards licensure. This checklist is provided for your
reference for your initial application, do not submit this checklist to the Board. See the Overview of Licensure and
Examination Process and the step-by-step instructions for In-State Applicants and Out-of-State Applicants for
more information. Page 2 of this document begins detailed information regarding required submissions.
• If you have not taken the Examination for Professional Practice in Psychology (EPPP), see #1 below or on page 2
for more details.
• If you have already taken and passed the EPPP in another state, U.S. territory, or Canadian province and are
seeking psychologist licensure in California, see #2 below or pages 2 and 3 for more details.
Mailing address of the Board of Psychology: 1625 North Market Blvd., N-215, Sacramento, CA 95834

1. To apply for the Examination for Professional Practice in Psychology, submit the following in your
application packet:

Application and fee.

Ofcial doctoral transcript.

Original Supervision Agreement(s), if applicable: see page 2.

Verifcation of Experience (VOE) form(s) (1,500 hours minimum).

2. If you have already taken and passed the EPPP in another state, Canadian province, or U.S.
territory, you are to apply to take the California Psychology Law and Ethics Examination (CPLEE) as
your beginning step towards licensure in California. To apply for the CPLEE, submit the following in
your application packet:

Application and fee.


Original supervision agreement(s), if applicable: see page 2.

Verifcation of Experience (VOE) form(s) (3,000 hours total).

EPPP score transfer.

Ofcial certifcation of licensure, if applicable.

Certifcate of Professional Qualifcation (CPQ), if applicable.

Credential issued by National Register of Health Service Providers in Psychology (NRHSPP), if applicable.

Certifcate issued by the American Board of Professional Psychology (ABPP), if applicable.

PDE_24-070 (Rev. 02/22/2024)

www.psychology.ca.gov
P (916) 574-7720 / F (916) 574-8672
GAVIN NEWSOM, GOVERNOR
1625 North Market Blvd. N-215, Sacramento, CA 95834 BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY
CHECKLIST WITH DETAILED INFORMATION

1. To apply for the Examination for Professional Practice in Psychology, submit the following in your
application packet:

Application and Fee: For First-Time Applicants Only


• Apply online and make a $236 payment via BreEZe.
• Note: An application will not be assigned to the processing queue until the required fee is received and processed.
• Note: If you have previously applied for licensure as a psychologist in California, mail a completed Application for Licensure
as a Psychologist and a $236 check payable to the California Board of Psychology.
Ofcial Doctoral Transcript
• Ofcial transcript(s) for the qualifying degree must be sent to the Board in one of the following three ways:
» Submitted electronically by the educational institution to [email protected] (recommended).
» Mailed directly to the Board by your educational institution.
» Mailed in an envelope that has been sealed and signed by the educational institution.
• Transcripts must refect the degree conferred and awarded date.
Original Supervision Agreement(s)
• Must be completed, signed, and dated by all parties prior to commencement of the supervised professional
experience (SPE).
• Mail to the Board in a sealed envelope signed across the seal by your primary supervisor unless already on fle
with the Board. Experience prior to preparation of a signed agreement will not count toward licensure.
• Note: Required for experience gained within California; not required for experience gained in another state, U.S. territory, or
Canadian province.
Verifcation of Experience (VOE) Form(s) (A minimum of qualifying 1,500 hours of SPE).
• Mail to the Board completed and signed VOE forms in a sealed envelope signed across the seal by your
primary supervisor.
• Experience gained within California: Complete page one of the VOE form.
• Experience gained outside of California or experience accrued prior to January 1, 2005: Complete both pages
of the VOE form.
Delivery Information
If you would like to know more about whether the Board has received your documents, you will need to use a mail
tracking service when mailing the documents to the Board. The Board will also send you a courtesy acknowledgment
of receipt via email after each of your documents have been received for applications submitted with the required fee.

2. If you have already taken and passed the EPPP in another state, Canadian province, or U.S.
territory, you are to apply to take the California Psychology Law and Ethics Examination (CPLEE) as
your beginning step towards licensure in California. To apply for the CPLEE, submit the following in
your application packet:

Application and Fee: For First-Time Applicants


• Apply online and make a $363 payment via BreEZe.
• Note: An application will not be assigned to the processing queue until the required fee is received and processed.
• Note: If you have previously applied for licensure as a psychologist in California, mail a complete Application for Licensure as
a Psychologist and a completed CPLEE request form along with a $363 check payable to the California Board of Psychology.

2
(Rev. 02/22/2024)
Original Supervision Agreement(s)
• Mail to the Board in a sealed envelope signed across the seal by your primary supervisor unless already on fle
with the Board.
• Must be completed, signed, and dated by all parties prior to commencement of the supervised professional
experience (SPE). Experience prior to preparation of a signed agreement will not count toward licensure.
• Note: Required for experience gained within the state of California; not required for experience gained in another state,
U.S. territory, or Canadian province.
Verifcation of Experience (VOE) Form(s) (A total of qualifying 3,000 hours of SPE)
• Mail to the Board completed and signed VOE forms in a sealed envelope signed across the seal by your
primary supervisor.
• Experience gained within California: Complete page one of the VOE form.
• Experience gained outside California or experience accrued prior to January 1, 2005: Complete both pages of
the VOE form.
EPPP Score Transfer
• Verifcation of Examination for Professional Practice in Psychology (EPPP) score to be submitted by the
Association of State and Provincial Psychology Boards (ASPPB) directly to the Board.
• Note: Optional if you have been licensed based on a doctoral degree in another state, Canadian province, or U.S. territory for a
minimum of two years.
If you have been licensed as a psychologist based on a doctoral degree in another state, Canadian province,
or U.S. territory, submit the following additional document:
Ofcial Certifcation of Licensure
• Attach an ofcial certifcation of licensure from your current licensing Board to your online application or mail
it to the Board along with your application packet.
If you have been licensed as a psychologist based on a doctoral degree in another state, Canadian province,
or U.S. territory for a minimum of two years and possess one of the following, you may submit verifcation of
supervised professional experience through one of the below certifcates or credential status in lieu of the
verifcation of experience form(s):
Certifcate of Professional Qualifcation (CPQ)
• Request verifcation of your CPQ from and to be submitted by the ASPPB directly to the Board.
See CPQ Program Info page on the ASPPB website for information.
Credential issued by National Register of Health Service Providers in Psychology (NRHSPP)
• Request verifcation of your credential from, and to be submitted by the NRHSPP. See NRHSPP website
for information.
Certifcate issued by the American Board of Professional Psychology (ABPP)
• Attach an ABPP verifcation letter to your online application or mail it to the Board along with your application
packet.
Delivery Information
If you would like to know more about whether the Board has received your documents, you need to use a mail
tracking service when mailing the documents to the Board. The Board will also send you a courtesy acknowledgment
of receipt via email after each of your documents have been received for applications submitted with the required fee.

3
(Rev. 02/22/2024)

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