You must complete this form and submit it with the appropriate licensure and initial registration fee ($294) directly to the Office of the Professions to apply for licensure in NYS. $294 is the total of the application fee ($115) plus the fee for your first registration period ($179). The application portion if the fee is not refundable. View the Profession Fee Chart at http://www.op.nysed.gov/documents/opfeechart.pdf. You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review.
Before you begin the application, you should review the requirements for licensure as a Psychologist at http://www.op.nysed.gov/prof/psych/psychlic.htm and How to Apply for Licensure as a Psychologist at http://www.op.nysed.gov/prof/psych/howtoapply.htm. Please take a moment to review the list of necessary information you will need to complete the application process.
- Contact Information (mailing & email addresses and phone number(s)).
- Information about any criminal (misdemeanor or felony) or professional disciplinary action. You will have the opportunity to upload relevant documents.
- Your name on your application must match the name on your photo ID.
- High school and college educational history (locations and attendance dates).
- Professional licensure in New York or another jurisdiction (profession, date of licensure and license number).
- Prior attempts on the Examination for Professional Practice in Psychology (EPPP) examination.
- If you did not complete the New York Child Abuse Identification and Reporting course work in your NYS registered program, you must submit a certificate of completion or exemption request.
- Payment information ($294 payment is only accepted by MasterCard, Visa, or American Express).
- To save and return to the application you must have a Social Security Number.
If you require assistance with the online application, click the Help link. Application fees are not refundable; it is your responsibility to know the requirements for licensure.
This is the application and fee for licensure as a Psychologist. You must also meet requirements for education, supervised experience and examination. You are responsible for having all other documentation submitted for review and approval by the Department.