Get La Sbep Temporary Registration 2013-2026

Filling out the Louisiana State Board of Examiners of Psychologists Temporary Registration form is a crucial step for out-of-state psychologists seeking to practice temporarily in Louisiana. This guide will walk you through each section and field of the form, ensuring you complete it accurately.

Follow the steps to successfully complete your registration.

1. Click the ‘Get Form’ button to access the registration form and open it in your document editor.
2. Attach a current passport-sized photo on the first page of the application, along with a copy of a valid driver's license or another recognized photo identification.
3. Include documentation verifying that your state of residence offers similar privileges to that of Louisiana for practicing psychology.
4. Provide a copy of your current and unrestricted license to practice psychology at the doctoral level from your state of residence.
5. In Part I: General Information, fill in your full name, maiden or alias name, social security number, date and place of birth, and contact details including home and business phone numbers, email address, and addresses.
6. In Part II: License History, indicate your state of residence and whether you are licensed for independent practice of psychology. Provide your license number, original issue date, and expiration date if applicable.
7. List information on any additional jurisdictions where you hold or have held a professional license, including the jurisdiction, license number, original issue date, expiration date, and area of practice.
8. In Part III: Dates and Location of Practice in Louisiana, state whether your temporary practice is associated with a professional organization or group, and provide the organization name and contact details.
9. Specify the location and dates of your temporary practice in Louisiana, and describe the specific psychological duties to be provided during this period.
10. Complete Part IV: Attestation, Identification, and Affidavit by answering the questions honestly and attaching explanations on a separate page if you answer ‘Yes’ to any questions regarding discipline or convictions.
11. Sign the notarized affidavit section, confirming that your statements are true, and that you understand the conditions of the temporary registration.
12. After completing all sections, save your changes. You can then download, print, or share the form as needed.

Complete your LA SBEP Temporary Registration online today to ensure a smooth process.