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Virginia Administrative Code
Title 18. Professional And Occupational Licensing
Agency 125. Board of Psychology
Chapter 20. Regulations Governing the Practice of Psychology
12/22/2024

FORMS (18VAC125-20).

Application Instructions For Clinical Psychology (LCP), School Psychology, or Applied Psychology Licensure by Examination (rev. 4/2018)

Endorsement Application Instructions for Licensure as a Clinical, School, or Applied Psychologist (rev. 12/2018)

Application Instructions for Licensure as a School Psychologist-Limited (rev. 5/2018)

Employment Verification (rev. 5/2018)

Registration of Residency in Clinical or School Psychology (Post-Graduate Degree Supervised Experience) (rev. 5/2018)

Psychologist Application for Reinstatement of a Lapsed License (rev. 5/2018)

School Psychologist-Limited Application for Reinstatement of a Lapsed License (rev. 5/2018)

Psychologist/CSOTP Application for Reinstatement Following Disciplinary Action (rev. 5/2018)

Verification of Post-Degree Supervision (rev. 5/2018)

Internship Verification (rev. 5/2018)

Licensure/Certification Verification (rev. 5/2018)

Areas of Graduate Study (rev. 5/2018)

Continuing Education Summary Form (rev. 12/11)

Verification of Pre-Doctoral Supervised Practicum Hours (eff. 5/2018)

Verification of Post-Licensure Active Practice (rev. 8/2018)

Licensure Verification of Out-of-State Supervisor (rev. 5/2018)

Form for Reporting Psychology Grand Rounds Attendance (rev. 10/2011)

Continuing Education/Course Approval Request (rev. 4/2018)

Request for Board Approval of Evaluator (rev. 10/2017)

Request for Board Approval of Practice Supervisor (rev. 10/2017)

Request for Board Approval of Therapist (rev. 10/2017)

Psychology Name/Address Change Form (rev. 3/2016)

Request for Verification of Virginia Psychology License (rev. 7/2017)

Request for Change in Status of Virginia Clinical, School or Applied Psychologist License and School Psychologist Limited License (Current Active to Current Inactive) (rev. 5/2020)

Request for Change in Status of Virginia Psychology License (Current Inactive to Current Active) (rev. 5/2020)

Request for Change in Status of Virginia Psychology License (Current Inactive to Current Active at Annual Renewal Time) (rev. 5/2020)

Website addresses provided in the Virginia Administrative Code to documents incorporated by reference are for the reader's convenience only, may not necessarily be active or current, and should not be relied upon. To ensure the information incorporated by reference is accurate, the reader is encouraged to use the source document described in the regulation.

As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.