REGULATIONS
Vol. 27 Iss. 25 - August 15, 2011

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF PSYCHOLOGY
Chapter 20
Forms

Title of Regulation: 18VAC125-20. Regulations Governing the Practice of Psychology.

Agency Contact: Elaine J. Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4688, FAX (804) 524-4434, or email elaine.yeatts@dhp.virginia.gov.

NOTICE: The following forms used in administering the regulation were filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name to access a form. The forms are also available through the agency contact or at the Office of the Registrar of Regulations, General Assembly Building, 2nd Floor, Richmond, Virginia 23219.

FORMS (18VAC125-20)

Instructions for Virginia Board of Psychology Application for Licensure by Examination (rev. 10/03).

Instructions for Virginia Board of Psychology Application of Licensure by Endorsement (rev. 10/03).

Instructions - Virginia Board of Psychology Application for Licensure by Examination (rev. 2/10).

Instructions - Virginia Board of Psychology Application of Licensure by Endorsement (rev. 2/10).

Psychologist Application for Licensure by Examination, Form 1 (rev. 8/07).

Application for Licensure as a School Psychologist-Limited (rev. 8/07).

Employment Verification Form (rev. 8/07).

Registration of Residency -- Post-Graduate Degree Supervised Experience, Form 2 (rev. 8/07).

Psychologist Application for Licensure by Endorsement, Form 1 (rev. 8/07).

Psychologist Application for Reinstatement of a Lapsed License, PSYREIN (rev. 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. 8/07).

Verification of Post-Degree Supervision, Form 3 (rev. 8/07).

Internship Verification, Form 4 (rev. 8/07).

Licensure/Certification Verification, Form 5 (rev. 8/07).

Areas of Graduate Study, Form 6 (rev. 8/07).

Areas of Graduate Study, Form 6 (rev. 2/10).

Continuing Education Audit Summary Form (rev. 4/09).

VA.R. Doc. No. R11-2939; Filed July 25, 2011, 3:51 p.m.