Virginia Board of Psychology
Applications & Forms
The below documents are in Microsoft Word format. If you do not have Microsoft Word, you can get the Microsoft® Word Viewer 97/2000 to view and print DHP's documents.
In addition to downloading the forms listed under Psychology Forms, you are required to carefully review the Statutes and Regulations Governing the Practice of Psychology, which can be accessed at this site under Laws and Regulations Governing Psychology. These documents include requirements for licensure in the Commonwealth of Virginia and are to be used as a primary guide.
Please Note: Click here for the Application Deadlines for 2008.
Psychologist Forms
Endorsement Forms
Psychologist Application for Licensure by Endorsement to include CPQ/National Register/ABPP
Application for Licensure by Endorsement Instructions
Licensure/Certification Verification
Request of Transfer Score (This is a PDF file, you'll need the free Adobe Acrobat Reader to view this form.)
Examination Forms
Psychologist Application for Licensure by Examination (Form 1)
Post Degree Supervision Registration - Registration of Residency (Form 2)
Verification of Post Degree Supervision (Form 3)
Internship Verification (Form 4)
Licensure/Certification Verification from Another Jurisdiction (Form 5)
Area of Graduate Study (Form 6)
Request of Transfer Score (This is a PDF file, you'll need the free Adobe Acrobat Reader to view this form.)
Reinstatement Forms
Application for Reinstatement following Disciplinary Action
Application for Reinstatement of a Lapsed License
School Psychologist Limited
Instructions for completing an application for School Psychologist Limited
Application for Licensure as a School Psychologist Limited
School Psychologist-Limited Application for Reinstatement of a Lapsed License
Sex Offender Treatment Providers
General Information for Certification as a Sex Offender Treatment Provider
Application for Certification, (Form 1)
Licensure/Certification Verification, (Form 2)
Verification of Post-Degree Supervision, (Form 3)
Licensure Verification for Out-of-State Supervisor (Form 4)
Registration of Post-Graduate Degree Supervised Experience (Form 5)
Registration of Supervision Instructions
Application for Reinstatement of Certification as a Sex Offender Treatment Provider
ContinuingEducation Provider Forms
Application for Approval as a "Paragraph B" Continuing Education Provider
Licensee Continuing Education Forms
Continuing Education Experience Summary Form