Get Ca Board Of Psychology Verification Of Experience Form 2022-2025

Completing the CA Board Of Psychology Verification Of Experience Form online is a crucial step in your journey to become a licensed psychologist in California. This guide will provide you with detailed information to help you navigate each section of the form with ease.

Follow the steps to successfully fill out the form online.

1. Press the ‘Get Form’ button to obtain the form and view it in the online editor.
2. Begin by entering your personal information in the 'Trainee' section. Provide your last name, first name, middle initial, date of birth, email address, and phone number.
3. Next, fill out the 'Primary Supervisor' section. Complete the supervisor's last name, first name, email address, phone number, license type and number, jurisdiction, and license issue date. If you are a training director, check the 'Yes' box.
4. In the 'Verification of Experience' section, input the start date and completion date of the supervised experience. Then, provide the average number of hours worked per week, number of hours of direct supervision per week, and total hours of verified experience.
5. Specify the organization where the services were provided by entering the organization name, street address, city, state, and zip code. Indicate whether this was an official placement overseen by the APA, APPIC, or CAPIC.
6. In the ‘Duties’ section, give a detailed description of the psychological duties that were included in the supervised professional experience.
7. Review all filled sections to ensure that they are accurate and complete. It's essential to avoid any omissions that could delay the application process.
8. After completing the form, save any changes you have made. You can then download, print, or share the completed form as required.

Complete your application by filling out the necessary documents online.