TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
NOTICE: The following forms have been filed by the Board of Psychology. The forms are available for public inspection at the Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, Virginia 23233, or at the Office of the Registrar of Regulations, General Assembly Building, 2nd Floor, Richmond, Virginia 23219. Copies of the forms may be obtained from Elaine Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4688, or email elaine.yeatts@dhp.virginia.gov.
Titles of Regulations: 18VAC125-20. Regulations Governing the Practice of Psychology.
18VAC125-30. Regulations Governing the Certification of Sex Offender Treatment Providers.
FORMS (18VAC125-20)
Instructions for Virginia Board of Psychology Application for Licensure by Examination (rev. 1/03 10/03).
Instructions for Virginia Board of Psychology Application of Licensure by Endorsement (rev. 1/03 10/03).
Psychologist Application for Licensure by Examination, Form 1 (rev. 1/03 8/07).
Application for Licensure as a School Psychologist-Limited (rev. 1/03 8/07).
Employment Verification Form (rev. 1/03 8/07).
Registration of Residency—Post-Graduate Degree Supervised Experience, Form 2 (rev. 1/03 8/07).
Psychologist Application for Licensure by Endorsement, Form 1 (rev. 1/03 8/07).
Psychologist Application for Reinstatement of a Lapsed License, PSYREIN (rev. 1/03 8/07).
School Psychologist-Limited Application for Reinstatement of a Lapsed License, PSYREIN (rev. 8/07).
Psychologist Application for Reinstatement Following Disciplinary Action, PSYREDISC (rev. 1/03 8/07).
Verification of Post-Degree Supervision, Form 3 (rev. 1/03 8/07).
Internship Verification, Form 4 (rev. 1/03 8/07).
Licensure/Certification Verification, Form 5 (rev. 1/03 8/07).
Areas of Graduate Study, Form 6 (rev. 1/03 8/07).
Renewal Notice and Application, 0803, 0810, 0811 (rev. 1/03).
Renewal Notice and Application, 0814 (rev. 1/03).
Application for Approval as a “Paragraph B” Continuing Education Provider (rev. 8/07).
Continuing Education Audit Summary Form (rev. 8/07).
FORMS (18VAC125-30)
General Information for Certification as a Sex Offender Treatment Provider (rev. 4/02 8/07).
Application for Certification as a Sex Offender Treatment Provider, SOTP Form 1 (rev. 4/02 8/07).
Licensure or Certification Verification of Applicant, SOTP Form 2 (rev. 4/02 8/07).
Sex Offender Treatment Provider, Verification of Supervision, SOTP Form 3 (rev. 4/02 8/07).
Licensure Verification of Out-of-State Supervisor, SOTP Form 4 (rev. 4/02 8/07).
Registration of Supervision Instructions (rev. 4/02 8/07).
Registration of Supervision, Post-Graduate Degree Supervised Experience, SOTP Form 5 (rev. 4/02 8/07).
Application for Reinstatement of Certification as a Sex Offender Treatment Provider (rev. 4/02 8/07).
Renewal Notice and Application (rev. 9/01).
VA.R. Doc. No. R09-1580; Filed August 27, 2008, 12:00 p.m.