Applications and Forms
Application - Entire Packet
Note: If you are having problems downloading this application, call PCS at 1-877-887-9727.
Sections
- Instruction Form
- Main Application Form
- Checklist
- Coursework Verification Form
- Pre- and Post-Doctoral Experience Form
- Internship Director Form
- Supervisor/Collaborator Form
- Professional and Ethical Reference Form
- Academic Program Director Form
- How To Avoid Having Your Application DeniedOnline Address Change for Psychologists
The Online Change of Address feature allows you to change your address of record listed in our database. To use this function, you must provide certain information for authorization.
Change of Name or Request for Duplicate License for Board of Registration of Psychologists
This PDF form maybe used to request a name change, address change or a duplicate license.
Division of Professional Licensure Complaint Form
Health Care Fraud Complaint Application
Note: The Health Care Fraud Application is for use by insurance companies and fraud agencies.
Health Service Provider certification: What You Should Know