LICENSE APPLICATION FORMS
General Information:
RECIPROCITY APPLICATION: You may apply with this workflow ONLY if you are a Diplomate of the American Board of Professional Psychology (ABPP) or a holder of the Certificate of Professional Qualification in Psychology (CPQ) issued by ASPPB. Louisiana does not have reciprocity agreements with individual states or jurisdictions.
- Reciprocity Application
- Verification of Professional License
- Doctoral Program (submit form only if Doctoral Program was not APA approved)
- Criminal Background Check
- Information on Clinical Neuropsychology Specialization
- Clinical Neuropsychology Specialization
APPLICATION FOR LICENSED PSYCHOLOGIST: Use this workflow if do not qualify for Reciprocity, and you have either a) completed the EPPP and postdoctoral supervision requirements; b) completed postdoctoral supervision requirements and are seeking approval to be admitted to take the EPPP; or c) a qualified applicant for licensure not seeking early admission to the EPPP.
- Licensing Flow Chart – Psychologists w/ 2 years supervised practice experience
- Steps Toward Licensure – Psychologists
- Application Form: Psychologist
- Doctoral Program (submit form only if Doctoral Program was not APA approved)
- Practicum (Required)
- Internship Documentation (Required)
- Criminal Background Check
- Supervised Practice Plan
- Supervised Practice Plan -PROVISIONAL ONLY (Required for Provisional Applicants)
- Post Doctoral Supervision Documentation form (Required)
- Verification of Professional License (Required if you are licensed by any other regulatory board)
- Verification of Degree Form (Required if you began your postdoctoral supervision prior to the date your degree was conferred on your transcripts)
- Information on Clinical Neuropsychology Specialization
- Clinical Neuropsychology Specialization
APPLICATION FOR PROVISIONAL LICENSE: Use this workflow if you have completed your doctorate degree in psychology through an acceptable institution defined by the Louisiana Administrative Code, Title 46, Part LXIII. Psychologists, Chapter 3. Provisional Licensure REQUIRES Supervision by a Licensed Psychologist in Louisiana. Provisional Licensees are eligible to take the national Examination for Professional Practice in Psychology and Jurisprudence Examination prior to completing the postdoctoral supervision requirements. Applicants may forgo provisional licensure and opt to complete all examination requirements after completing supervision.
- Licensing Flow Chart – Provisional Licensure w/ 1 year supervised practice experience
- Steps Toward Licensure – Provisional Licensure
- Application Form: Provisional License
- Doctoral Program (submit form only if Doctoral Program was not APA approved)
- Practicum (Required)
- Internship Documentation (Required)
- Criminal Background Check
- Supervised Practice Plan
- Supervised Practice Plan -PROVISIONAL ONLY (Required for Provisional Applicants)
- Post Doctoral Supervision Documentation form (Required)
- Verification of Professional License (Required if you are licensed by any other regulatory board)
- Verification of Degree Form (Required if you began your postdoctoral supervision prior to the date your degree was conferred on your transcripts)
- Information on Clinical Neuropsychology Specialization
- Clinical Neuropsychology Specialization
LICENSED SPECIALIST IN SCHOOL PSYCHOLOGY (LSSP): This application is for individuals who have completed a school specialist degree from a National Association of School Psychologists approved program or equivalent, three years of supervised as a certified school psychologist within the public school system and has passed the Nationally Certified School Psychologist examination. LSSP's are limited to practice as a contractor or employee of a public, private, or charter school system. Supervision is required outside of these settings.
- Application Form: Licensed Specialist in School Psychology (LSSP)
- Summary of Fees
- LSSP Application Flow Chart
- Verification of Professional License
- Criminal Background Check
- Verification of Graduate Program of Study (REQUIRED IF YOU DID NOT ATTEND A NASP ACCREDITED PROGRAM)
- PRAXIS Examination Score Report Request (REQUIRED IF YOU DO NOT HOLD AN NCSP)
- Internship Experience Documentation (REQUIRED IF YOU DO NOT HOLD AN NCSP)
- School Supervised Experience Documentation (REQUIRED IF YOU DO NOT HOLD AN NCSP)
REINSTATEMENT OF LAPSED LICENSE
- Reinstatement Application for Psychologist
- Reinstatement Application for LSSP
- Verification of Professional License
- CPD Verification Form
- Criminal Background Check
REQUIRED: PUBLIC DISPLAY OF BOARD ADDRESS
COMPLAINT FORMS
Request for Investigation
Consent Release
2021 LICENSEE RENEWAL FORMS
CONTINUING PROFESSIONAL DEVELOPMENT (CPD) VERIFICATION FORM(To be completed for and retained for your records when claiming credit for peer consultation, continuous practice outcome measure, professional activities, and self-directed learning activities.)
2021 Licensed Psychologist Continuing Professional Development Report
2021 Licensed Specialist in School Psychology Continuing Professional Development Report
2021 Fee Reduction Application
2021 Continuing Education Extension Application
NOTICE: In compliance with Act 655 of the 2018 Regular Session, the LSBEP hereby gives notice to its licensees and applicants of their opportunity to file a complaint about board actions and board procedures. You may submit such complaints to one or more of the following organizations: •Louisiana State Board of Examiners of Psychologists:Submit in writing to: LSBEP, 4334 S. Sherwood Forest Blvd., Suite C-150, Baton Rouge, LA 70816; admin.lsbep@la.gov; (225)295-8410 •Committee on House & Governmental Affairs, La. House of Representatives:Submit to: H&GA@legis.la.gov or Committee on House & Governmental Affairs, La. House of Representatives, PO Box 44486, Baton Rouge, LA 70804; (225) 342-2403 •Committee on Senate & Governmental Affairs; La Senate:Submit to: s&g@legis.la.gov or Committee on Senate & Governmental Affairs; La Senate PO Box 94183, Baton Rouge, LA 70804; (225)342-9845
NOTICE: In compliance with La. R.S. 44:33.1, the LSBEP hereby gives notice that information submitted to the LSBEP may become public record pursuant to the provisions of Louisiana Public Records Law, La. R.S. 44:1, et seq.