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Applications & Forms

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 make a selection from the dropdown to view the associated forms.

In addition to downloading the forms listed below, you are required to carefully review the Statutes and Regulations Governing the Practice of Psychology, which can be accessed at this site under Practitioner Resources - Laws and Regulations. These documents include requirements for licensure in the Commonwealth of Virginia and are to be used as a primary guide.

Endorsement Application and Forms

Application for Licensure as a Clinical Psychologist by Endorsement

Licensure/Certification Verification from Another Jurisdiction

Areas of Graduate Study for Clinical Psychologist

Verification of Active Practice - Clinical Psychologist

 

Examination Application and Forms

Application for Licensure as a Clinical Psychologist by Examination

Application for Initial Registration of Residency for Clinical Psychology

Application for Add/Change Supervisor for Registration of Residency for Clinical Psychology

Verification of Post-Degree Supervision for Clinical Psychology

Internship Verification for Clinical Psychologist License

Licensure/Certification Verification from Another Jurisdiction

Areas of Graduate Study for Clinical Psychologist

Supervisor's Out-of-State Licensure Verification Form

Verification of Pre-Doctoral Supervised Practicum Hours

Sample of a Resident in Clinical Psychology Supervisory Contract

Request for Termination of Supervision - Resident in Clinical Psychology

Reactivation

Request for Change in Status of Virginia Psychology License (Current Inactive to Current Active at Annual Renewal Time)

In addition to downloading the forms listed below, you are required to carefully review the Statutes and Regulations Governing the Practice of Psychology, which can be accessed at this site under Practitioner Resources - Laws and Regulations. These documents include requirements for licensure in the Commonwealth of Virginia and are to be used as a primary guide.

Application for Licensure as a School Psychologist-Limited

Employment Verification Form

Licensure/Certification Verification from Another Jurisdiction

Reactivation

Request for Change in Status of Virginia Psychology License (Current Inactive to Current Active at Annual Renewal Time)

Virginia Board of Psychology
psy@dhp.virginia.gov
Jaime Hoyle, Executive Director
J.D. Ball, Ph.D., ABPP, Board Chair