Florida Regulations 64B19-11.012: Application Forms
Current as of: 2024 | Check for updates
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(1) All applicants for licensure pursuant to Florida Statutes Chapter 490, shall complete and submit form DH-MQA 1187, (revised 04/22), “”Application for Licensure as a Psychologist,”” which is incorporated herein by reference and which may be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-14597, the Board office, or at http://floridaspsychology.gov/applications/psychology-licensure-app.pdf.
Rulemaking Authority 456.013, 456.025, 490.004(4), 490.005 FS. Law Implemented 456.013, 456.025, 456.0635, 490.005, 490.006 FS. History-New 6-25-02, Amended 5-24-09, 3-1-10, 5-23-10, 11-10-11, 6-18-12, 12-25-12, 10-28-13, 5-1-14, 11-2-14, 4-6-15, 12-3-15, 4-21-16, 9-27-16, 11-23-17, 2-18-19, 3-28-21, 6-21-21, 10-19-21, 8-22-22.
(2) An applicant who is a diplomate in good standing with the American Board of Professional Psychology, Inc., and who wishes to apply for licensure by endorsement pursuant to Section 490.006(1)(a), F.S., shall submit as part of his or her application PY FORM 4.abpp (rev. 07/21), “”ABPP Diplomate Verification Form,”” which is incorporated herein by reference and which may be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-13615, the Board office, or at https://floridapsychology.gov/applications/abpp-diploma-verification-form.pdf.
Rulemaking Authority 456.013, 456.025, 490.004(4), 490.005 FS. Law Implemented 456.013, 456.025, 456.0635, 490.005, 490.006 FS. History-New 6-25-02, Amended 5-24-09, 3-1-10, 5-23-10, 11-10-11, 6-18-12, 12-25-12, 10-28-13, 5-1-14, 11-2-14, 4-6-15, 12-3-15, 4-21-16, 9-27-16, 11-23-17, 2-18-19, 3-28-21, 6-21-21, 10-19-21, 8-22-22.