Texas State Board of Examiners of Psychologists Application

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					Texas State Board of Examiners of
Psychologists


Application Materials for:
Licensed Specialist in School Psychology

          01- LSSP Application Form
          02- Checklist for LSSP Licensure
          03- Criminal Record Instructions
          04- FAST Criminal Record Form
          05- Jurisprudence Examination Brochure
          06- Three (3) Reference Letters
          07- Documentation of Experience form
          08- Types of Licensure information sheet
          09- Providers of School Psychological Services information sheet
          10- Fee Schedule



Last Updated: August 2012




Texas State Board of Examiners of Psychologists
LSSP Application Form
                                01- LSSP Application Form




Texas State Board of Examiners of Psychologists
LSSP Application Form
                                       TEXAS STATE BOARD OF EXAMINERS
                                              OF PSYCHOLOGISTS
                                             333 Guadalupe, Suite 2-450
                                                Austin, Texas 78701
                                                  (512) 305-7700
                                                                                                          Official Use Only


                                                       Application for
                                               Specialist in School Psychology
                                                       (Board Rule §463.9)

PLEASE PRINT OR TYPE

A.     Name
                                       First                            Middle                            Last            Degree

       Social Security Number                      -             -               .       Male________     Female_________

B.     E-mail address:_______________________________________________________________________________________

C.     Mailing Address
                                       Street or P.O. Box               City                    State              ZIP

D.     Home Telephone: (           )                                    Business Telephone: (     )

E.     Date of Birth                                                    Place of Birth
                          mo-day-yr                                                      City             County          State

F.     Have you taken the Texas Board’s Jurisprudence Examination?                              If yes,

       When                                                             Your Score
                                mo-day-yr

G.     Have you taken the National School Psychology Examination?                               If yes,

       When                                             Where                            Your Score
                       mo-day-yr

H.     If you have a disability or impairment which will necessitate special accommodations, facilities or procedures during the
       administration of the examination(s), please specify your condition in writing when submitting your application. Your
       request for special accommodations, facilities or procedures must be accompanied by a physician’s certification of your
       condition.




I.     Degree Earned:

       Degree Granting Institution


Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 1 of 8
         Area of Training

         Title of Program

         Date Degree Granted
                                                                         Month/Day/Year

J.       Type of Degree: (select one)

                   1.       Doctoral Degree in Psychology

                   2.       A degree from a country other than the United States (if so, submit documentation which satisfies the
                            requirements of Board rule §463.25)

                   3.       Specialist’s Degree in Psychology

                   4.       Master’s Degree in Psychology

K.       Graduate Degree Information:

         1.       Committee Chair or Graduate Advisor’s Name

         2.       Title of master’s thesis or doctoral dissertation (if applicable)

NOTE: If you hold a current valid NCSP certification or have graduated from a training program approved by the NASP or
      accredited in school psychology by APA, you do not have to complete Section L.l.

L.       Education/Training (requirements of Rule 463.9)

         1.   In the space provided, please list all courses required in Board rule 463.9. PLEASE READ RULE 463.9. Note, a course
              may be listed in no more than three (3) areas and preferably in only one area. Each area must have at least one course
              listed.




                                                                  COURSE                                                SEMESTER
     TITLES OF COURSE                                             PREFIX                                                 CREDIT
          WORK                 UNIVERSITY/COLLEGE              (e.g. PSY 301)         DESCRIPTIVE COURSE TITLE            HOURS

 1. Biological Bases of
 Behavior



 2. Human Learning




 3. Social Bases of
 Behavior




Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 2 of 8
  TITLES OF COURSE            UNIVERSITY/COLLEGE      COURSE        DESCRIPTIVE COURSE TITLE   SEMESTER
       WORK                                           PREFIX                                     CREDIT
                                                   (e.g. PSY 301)                                HOURS

 4. Multicultural Bases of
 Behavior




 5. Child or Adolescent
 Development




 6. Psychopathology or
 Exceptionalities




 7. Research and Statistics




 8. Instructional Design




 9. Organization and
 Operation of Schools




 10. Psychoeducational
 Assessment




 11. Socio-Emotional,
 including Behavioral
 and Cultural,
 Assessment


 12. Counseling




Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 3 of 8
                                                               COURSE                                                   SEMESTER
  TITLES OF COURSE                                             PREFIX                                                    CREDIT
       WORK                   UNIVERSITY/COLLEGE            (e.g. PSY 301)      DESCRIPTIVE COURSE TITLE                  HOURS

 13. Behavior
 Management




 14. Consultation




 15. Professional, Legal
 and Ethical Issues




 16. Practicum




        2.       Indicate internship required in Board rule 463.9. Attach extra pages if necessary.

                 a.        Place of internship




                 b.        Dates of internship
                                                           mo-day-yr                        to                          mo-day-yr
                 c.        Hours you worked per week

                 d.        Indicate name and current address of supervisor(s) who will document hours of supervision.


                           Name                                                 Street or P.O. Box


                           City                                                 State                                       ZIP

                 e.        Was supervisor a licensed psychologist?              YES               NO

                 f.        Was supervisor an LSSP?                              YES               NO

                 g.        Was supervisor credentialed to practice school psychology in the jurisdiction where the supervision
                           occurred?
                           YES            NO


Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 4 of 8
               h.       Did supervisor have a minimum of three (3) years of experience providing psychological services in the
                        schools?

                        YES               NO

               i.       In what jurisdiction was supervisor licensed?

M.     Please provide a chronology of all your education, training, internships and employment since enrolling in your master’s or
       doctoral program. If there are any gaps in the chronology, please explain. Use extra pages if necessary. Note: if you have
       provided this information in conjunction with a previous application to this board in the last three years, you do not
       have to complete section M.

                                                                                              DESCRIPTION OF EDUCATION,
                                                                                              TRAINING, INTERNSHIP AND
       FACILITY AND ADDRESS                    DATES          SUPERVISOR’S NAME               EMPLOYMENT




N.     Other Certification or License

       Have you ever been certified and/or licensed as a psychologist in this or any other state/province (including NCSP)?

       ____________              If yes, please provide the following information (use extra pages if necessary):

       1.      Credentialed as



Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 5 of 8
                a.       Jurisdiction where credentialed

                         Date credentialed                                                Credential Number

                         Expiration date of current credential
                                                                                               mo-day-yr

                b.       With master’s or specialist’s degree                                       Doctoral degree

                c.       Name of credentialing agency

                d.       Address of credentialing agency
                                                                                    Street or P.O. Box


                                  City                                           State/Province                               Zip

                e.       Has any complaint ever been filed against this credential?

                f.       If so, state nature and resolution of this complaint (use extra pages if necessary).



O.     Have you ever been arrested for any reason or convicted of any criminal offense in this or any other jurisdiction?
       If yes, please attach an explanation and supporting legal documents for each separate incident.

P.     Have you ever practiced psychology without a license or exemption in this or any other jurisdiction?

       ______________             If yes, please attach an explanation.

Q.     Have you ever aided or abetted another individual in practicing psychology without a license or exemption in this or any
       other jurisdiction?

                                  If yes, please attach an explanation.

R.     Is there any reason why you are not physically or mentally competent to render psychological services with reasonable skill,
       safety and competency?

                                  If yes, please attach an explanation.

S.     Do you use drugs or intoxicating liquors to an extent that affects your professional competency?
       If yes, please attach an explanation.

T.     Is there any action pending against you or against any mental health license that you hold in this or any other jurisdiction?

       ________________           If yes, please attach an explanation.

U.     Have you ever had any professional license to practice in a mental health profession refused or denied, suspended, revoked,
       canceled, or otherwise disciplined?

                                  If yes, please attach an explanation and a copy of pertinent orders or decisions.

V.     Current Employment

       1.       Employer’s Name




Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 6 of 8
       2.      Employer’s Address
                                                                                  Street or P.O. Box


                        City                                                      State                                  Zip

       3.      Hours you worked per week                                          Job Title

       4.      Date employment began                                              Psychological Services Rendered




       5.      Supervisor’s Name
       6.      Supervisor’s Credentials (check one)                              Certified Psychologist
                                                                                 Licensed Psychologist
                                                                                 LSSP
                                                                                 Neither

       7.      Does supervisor have a minimum of three (3) years of experience providing psychological services in the schools?

               YES               NO

       8.      Jurisdiction where supervisor certified/licensed

       9.      Current title/position of supervisor

       10.     Supervisor’s Address
                                                                         Street or P.O. Box


                        City                                                      State                                             Zip

W.     Are you presently providing psychological services in Texas?                           If yes, are you: (please check one)

              Currently licensed by this Board?                        If so, state type of license
              Employed in a statutorily exempt agency as defined in Section 501.004 of the Psychologists’ Licensing Act. (A
               public school is NOT an exempt agency).

               If so, state name of agency
              If neither of the above, please attach an explanation.




Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 7 of 8
PERSONAL ACKNOWLEDGMENT

By signing in the space provided, I understand and acknowledge the following:

I acknowledge that the information contained in this application is true and correct.

In making this application to the Texas State Board of Examiners of Psychologists for the issuance of a license, I agree to abide by the
rules and regulations of the Texas State Board of Examiners of Psychologists and to take all examinations necessary to the processing
of my application. I further agree that the fee submitted with this application is NON-REFUNDABLE.

I hereby grant the Board permission to seek any information or references it deems fit in securing my credentials, pertinent to this
application.

I further agree that if issued a license, it shall remain the property of the Texas State Board of Examiners of Psychologists and shall be
returned if my license is suspended, revoked, voided or I resign or go on inactive status.

I have read the Psychologists’ Licensing Act, am familiar with, and agree to abide by the requirements of the Act, and Rules and
Regulations of the Board.

I understand that the Public Information Act is enforced as required by State law.




                          Signature                                                            Date




LSSPAPP – May 24, 2010




Texas State Board of Examiners of Psychologists
LSSP Application Form

Page 8 of 8
                       02- Checklist for LSSP Licensure




Texas State Board of Examiners of Psychologists
Checklist for Licensure as a Specialist in School Psychology
                                        Checklist for Application
                                            for Licensure as a
                                      Specialist in School Psychology

I.      To ensure that your application for licensure as a specialist in school psychology is
        processed as efficiently as possible, please submit the following to the Texas State Board
        of Examiners of Psychologists:

        A.      Completed application form (a vita is not a satisfactory substitute). Be sure to
                include complete names and addresses of supervisors. Also, be sure to sign the
                last page of the form.

        B.      Application Fee: A fee of $220 (non-refundable), payable to the Texas State
                Board of Examiners of Psychologists (T.S.B.E.P.), to cover the cost of the
                Board’s consideration of your request for licensure.

        C.      One of the following, as applicable:

                Documentation indicating that you hold current certification as a Nationally
                Certified School Psychologist by the National School Psychology Certification
                Board. You may obtain this documentation from the website of this organization
                and then mail it to the Board.

                                                     OR

                If you are not credentialed by the National School Psychology Certification
                Board, your application must indicate that you have taken and passed, at the
                approved pass rate set by the Board (660 if taken before 9/13/08; 165 if taken
                9/13/08 or thereafter), the National School Psychology Examination
                (administered by the Educational Testing Service, telephone number 800-772-
                9476) and the date you took and passed this exam. Also, your score on the
                National School Psychology Examination must be sent directly to the Board
                office from ETS.

        D.      Official Transcript(s) for all post-baccalaureate course work. The transcript(s)
                must be sent directly from your school(s), and must show the date the degree was
                conferred.

        E.      Three (3) acceptable reference letters. The Board requires a minimum of three
                references from psychologists or specialists in school psychology (LSSPs) or are
                credentialed in school psychology in their respective jurisdictions. CURRENT
                BOARD MEMBERS MAY NOT BE USED AS REFERENCES. The applicant
                is responsible for securing his/her own reference letters from those persons
                identified as references on the application form. These original reference letters
                must be included with the application form sent to the Board by the applicant.

Texas State Board of Examiners of Psychologists
Checklist for Licensure as a Specialist in School Psychology

Page 1 of 3
        F.      If you are not credentialed by NASP and you were not graduated from a training
                program approved by NASP or accredited in school psychology by APA, you
                must also submit the Documentation of Supervised Experience form after it has
                been completed by your supervisor. This completed form must be submitted with
                your application. Please note that applicants who need to submit this form, need
                only to submit two (2) reference letters, not three (3).

        G.      DPS/FBI fingerprint criminal history record checks. In accordance with the
                separate instruction sheet, obtain a Texas and national criminal record check by
                submitting your fingerprints to the vendor, Integrated Biometric Technology
                (IBT).

        Items A, B, and E (and F for some applicants) must be received in the Board office as a
        complete packet to begin processing your application. Applications not including these
        items will not be accepted. Items C, D, and G can be received at a later date. However,
        do not delay in ordering these other items to avoid a delay in the processing of your
        application.

II.     In accordance with Board rules, applicants who have applied for this license and whose
        educational and internship qualifications meet Board requirements and who have passed
        the National School Psychology Exam will be notified by the Board that they have met
        the training requirements at which time they may practice under supervision for up to one
        year in the public schools, and during which year they are expected to pass the
        Jurisprudence Examination. Applicants are encouraged to take the Jurisprudence
        Examination as soon as they are approved by the Board to do so.

III.    Some information about the procedure may be helpful:

        A.      All required information (Board Rules §463.5 and §463.9) for your application
                file must be in the Board office for your file to be reviewed, i.e., all reference
                letters, transcripts, scores, etc. Your completion of the application is only the
                beginning of the process. It is your responsibility to call the Board office to
                determine whether all required information has been received.

        B.      After your application file is complete and has been reviewed, the Board requires
                approximately six weeks to communicate its decision to you in writing.

IV.     There are three (3) items which require special attention:

        A.      If you do not use this application form within the next three months, please check
                with the Board office to make sure information provided in this letter is still
                current (i.e., fees, application form, etc.).



Texas State Board of Examiners of Psychologists
Checklist for Licensure as a Specialist in School Psychology

Page 2 of 3
          B.        You cannot register to take the National School Psychology Examination through
                    the Board office. You must contact the Educational Testing Service directly in
                    order to register for this examination. Please note that you must have passed the
                    National School Psychology Examination prior to your application being
                    reviewed.

          C.        Board Rule §463.2 states an incomplete application remains in the active file for
                    ninety (90) days, at the end of which time, if still incomplete, it is void.

If your application is approved, we will ask you to submit the examination fees for the
Jurisprudence Examination (currently $210), payable to the Texas State Board of Examiners of
Psychologists. The examination fees are NOT the same as the application fees. PLEASE DO
NOT SEND EXAMINATION FEES WITH YOUR APPLICATION. If you have any questions,
contact the Application Division of the Board office.

PLEASE CHECK OVER THIS ENTIRE CHECKLIST BEFORE SUBMITTING YOUR
APPLICATION TO AVOID ANY DELAYS IN THE APPLICATIONS PROCEDURE.
LSSP Checklist – January 2012




Texas State Board of Examiners of Psychologists
Checklist for Licensure as a Specialist in School Psychology

Page 3 of 3
                    03 – Criminal Record Instructions




Texas State Board of Examiners of Psychologists
Criminal Record Instruction
              Instructions to Applicants for Obtaining Fingerprint
                     Criminal Record Checks for Licensure

NOTE: A Texas Department of Public Safety (DPS)/FBI fingerprint criminal history record
check that shows any criminal record of the applicant is valid for six (6) months only. If
licensure is not obtained within six months, the applicant may be required to obtain a new
DPS/FBI fingerprint criminal record check as a condition for licensure. Each type of license
applied for with the Board requires a new DPS/FBI fingerprint criminal history record check
unless the applicant already has one on file with the Board that is less than 18 months old and the
record check on file shows that the Board did not issue an eligibility order or deny licensure to
the applicant based on the applicant/licensee criminal record.

Required for Texas Applicants:
Process for Obtaining Fingerprint Criminal Record Checks

Applicants for licensure with the Texas State Board of Examiners of Psychologists (TSBEP)
who reside in Texas are required to obtain fingerprint criminal record checks through the
Fingerprint Applicant Service of Texas (FAST). This is a DPS program that provides electronic
capture and submission of your fingerprints. This is the fastest and highest quality option
available. Applicants should complete the Applicant Information Section of the FAST form
provided with the application packet available free of charge for download on the TSBEP
website. Then contact the FAST vendor, Integrated Biometric Technology (IBT), at 1-888-467-
2080 or visit htpp://www.ibtfingerprint.com to schedule an appointment online at one of the 70
vendor sites in Texas. The vendor will collect the total payment of $44.20. (Of this amount,
$34.25 is for Texas DPS and $9.95 is for the vendor service. However, as of March 19, 2012,
the DDPS amount will be reduced so that the total will be $41.45.) The vendor forwards the
electronic fingerprints to DPS.

An applicant for licensure may wish to complete his or her appointment for a fingerprint check
before submitting an application for licensure to the Board to avoid any possible delay in
processing their licensure application caused by the Board not receiving the criminal history
report.

Required for Out-of-State Applicants:
Process for Obtaining Fingerprint Criminal Record Checks

Applicants for licensure with the Texas State Board of Examiners of Psychologists (TSBEP)
who do not reside in Texas are required to obtain fingerprint criminal record checks for
licensure.

Persons wishing to become licensed in Texas are encouraged to obtain their fingerprint criminal
record check BEFORE they apply for licensure with the Board in order to avoid a delay in the
processing of their license applications. The potential out-of-state applicant should make their

Texas State Board of Examiners of Psychologists
Criminal Record Instruction

Page 2 of 2
request in writing to the Board to obtain the required out-of-state applicant fingerprint criminal
record check packet. There is no charge for this fingerprint packet. The packet will include the
fingerprint card to obtain the manual fingerprints, an instruction sheet about the process, a Texas
scan card authorization form, and a envelope addressed to the Texas vendor, Integrated
Biometric Technology (IBT). Per the instructions, the applicant must take the fingerprint card to
a law enforcement agency in the applicant’s state. Be prepared to pay a fee for having your
fingerprints inserted on the fingerprint card executed, as some agencies do charge a fee. The
fingerprints must be taken by appropriately trained law enforcement official. The fingerprint
card must also be signed by a law enforcement official in the appropriate block. Please follow
the directions on this form and provide all information on the form EXCEPT: Your No.; FBI
No.; Armed Forces No.; Miscellaneous No.; or Reason Fingerprinted.

After your fingerprints have been taken, please return the completed fingerprint card in the
envelope provided, along with the completed Texas scan card authorization form, and a check or
money order made payable to IBT in the amount of $44.20, to IBT, 1650 Wabash Avenue, Suite
D, Springfield, IL 62704. (Of this amount, $34.25 is for Texas DPS and $9.95 is for the vendor
service. However, as of March 19, 2012, the DPS amount will be reduced so that the total will
be $41.45.) The vendor forwards your digitized manual fingerprints to DPS.

If the Board receives an application for licensure from an out-of-state applicant to whom it has
not previously sent a fingerprint packet and/or received a fingerprint criminal record on will be
mailed the fingerprint packet in order that the applicant may obtain this mandated criminal
record check as a requirement for licensure.




Amended January 25, 2012




Texas State Board of Examiners of Psychologists
Criminal Record Instruction

Page 2 of 2
                    04 – FAST Criminal Record Form




Texas State Board of Examiners of Psychologists
FAST Criminal Record Form
For Texas Applicants (not for Out of State Applicants):

This document is your FAST Pass to be fingerprinted for a TX criminal history record check.
You must schedule a fingerprint appointment by visiting www.ibtfingerprint.com or by calling 1-888-
467-2080.
You may pay for FAST services online with a credit card or onsite with a check or money order
only.
Your fingerprints will be submitted to the TxDPS/FBI with results delivered to this agency within one
week.

      1.    Logon to www.ibtfingerprint.com and select Texas
      2.    After Language option, select: All Others for Reason Fingerprinted
      3.    Select: Option A-Electronic Submission
      4.    Select: Yes I have a FAST Pass
      5.    Enter: TX922240Z when prompted for Agency Number/ORI
      6.    Follow the prompts to enter your personal information and select service location, date and time.
      7.    Bring this completed form with you to your appointment.

Section One: Agency Information

Agency/ORI: TX922240Z Agency Name: Texas State Board of Examiners of Psychologists

Reason for Fingerprinting: Applicant for licensure

Agency Assigned Applicant number N/A                                      Original TCN ____________________________________________
                 (If required by Agency)                                          (If resubmission for rejected fingerprints)



Section Two: Applicant Information (To be completed by Applicant)

Applicant Last Name                                                                  First Name _______________ Middle Name                 __________________
                                           (please print)

Sex         Male       Female               Race _________             Ethnicity __________________ Skin Tone                 ______________________________
                                                       (W, B, A, I, O)                (Hispanic or Non-Hispanic)

Date of Birth _____________________ Height ___________ Weight ___________ Hair Color __________ Eye
Color _________________________________________________________________________________________________________________
                                                              (feet and inches)

Place of Birth __________________ Citizenship _________________
                    (state or country)                            (country)


Home Address          _______________________________________________________________________________________________________
                          Street Address                      City                                     State                        Zip




Texas State Board of Examiners of Psychologists
FAST Criminal Record Form

Page 1 of 2
Section 3: Service Center Information (To be completed by FAST Live Scan Operator)
Date Prints Taken _______________________ Amount Charged For Service $44.20*
Paid by:    Check          Money Order    Visa    MasterCard    Billing Acct _____________________________________

TCN __________________________________________________________________________________________________________________

       I HAVE COMPARED THE GOVERNMENT-ISSUED IDENTIFICATION PRESENTED BY THE APPLICANT AND
       ATTEST THAT TO MY BEST DETERMINATION, I HAVE FINGERPRINTED THE SAME PERSON.


Printed Name of LSO:__________________________________________________________

Signature of LSO: _____________________________________________________________


*As of March 19, 2012, the total is reduced to $41.45.




Updated January 25, 2012




Texas State Board of Examiners of Psychologists
FAST Criminal Record Form

Page 2 of 2
              05- Jurisprudence Examination Brochure




Texas State Board of Examiners of Psychologists
Jurisprudence Examination Brochure
                      Texas State Board of Examiners
                             of Psychologists

                                  JURISPRUDENCE
                                   EXAMINATION

                                            Nature and Purpose
The Jurisprudence Examination is required of all candidates for licensure and covers the Texas Psychologists’
Licensing Act, Board rules and regulations, and applicable Texas laws. Application procedures are available
through the Board office or the Board’s website (www.tsbep.state.tx.us).

The primary purpose of the examination is to ensure that all candidates for licensure have the necessary
familiarization and knowledge of applicable laws, and rules and regulations to practice effectively in the state of
Texas.

                                           Examination Content
The content areas for the Jurisprudence Examination were identified and developed by the Board’s Written
Examination Committee and include the following:

    •    Practice Administration
    •    Board Composition and Procedures
    •    Complaint, Disciplinary, and Rehabilitation Procedures
    •    Research Practices
    •    Licensing Requirements and Specialty Certification
    •    Professional Practice Rules and Guidelines
    •    Supervision Guidelines
    •    Teaching

The Jurisprudence Examination will continue to be updated and modified in accordance with changes in
applicable Board rules and regulations and state laws.

                                              Resource Materials
Current resource and study materials for the Jurisprudence Examination include the following:

    •    Psychologists’ Licensing Act
    •    Board Rules and Regulations
    •    Texas Health and Safety Code

Texas State Board of Examiners of Psychologists
Jurisprudence Examination Brochure

Page 1 of 3
         Chapter 611 - Mental Health Records
         Texas Family Code
         Chapter 32 - Consent to Medical, Dental, Psychological and Surgical Treatment
         Chapter 153 - Rights of Parents and Other Conservators to Consent to Treatment of Children
         and Access to Children’s Records
         Chapter 261 - Duty to Report Child Abuse and Neglect
    •    Texas Human Resource Code Chapter 48 - Duty to Report Abuse of Elderly or Disabled Persons
    •    Texas Civil Practice and Remedy Code
         Chapter 81 - Duty to Report Sexual Exploitation of a Patient by a Mental Health Provider

All reference sources are necessary to adequately prepare for the examination. Although the sources listed are
relevant to the practice of psychology in Texas, they should not be considered all inclusive for any purpose. In
addition, please note that any statute and/or rule may be interpreted by case law and/or amended to influence its
applicability as a practical resource. It is important to note that this list is not intended to serve as a substitute for
legal advice nor does it constitute a guarantee of any kind to any individual. The Act and Rules may be accessed
through the Board’s website: www.tsbep.state.tx.us. Other Texas laws and related materials may be obtained
on-line at www.statutes.legis.state.tx.us or at a university or public library, as well as through other internet sources.

                                               Format and Scoring
The Jurisprudence Examination is in open-book format. The exam booklet and scantron answer sheet are sent by
delivery confirmation to the Board approved applicant upon receipt of the exam fee. The test must be completed
and all materials returned to the Board by certified mail within two weeks as indicated by the date stamped on the
test booklet.

The examination consists of approximately 100 multiple-choice items. Experimental items are included on the
exam in order to ensure an adequate item pool for future exams. Accordingly, the total item count for the
examination will vary from exam to exam. The minimum passing score for the exam will be 90% for PLPs and
LSSPs and 80% for LPAs. The average passing rate for first time examinees of the Jurisprudence Exam in 2007
was 90%.

                                                Examination Fees
The fee for administration of the Jurisprudence Examination is $210. This fee is non-refundable.

                                                      Questions
Questions regarding the administration of the Jurisprudence Examination should be directed to the licensing staff at
the Texas State Board of Examiners of Psychologists.

                                             Members of the Board
                                              Tim F. Branaman, Ph.D.
                                                       Chair
                                                       Dallas



Texas State Board of Examiners of Psychologists
Jurisprudence Examination Brochure

Page 2 of 3
                                  Lou Ann Todd Mock, Ph.D.
                                         Vice-Chair
                                           Bellaire

                                    Jeffrey M. Baker, Ph.D.
                                          League City

                                   Donna Lord Black, M.A.
                                          Fulshear

                                    Jo Ann Campbell, M.S.
                                           Abilene

                                       Carlos R. Chacon
                                            Austin

                                    Angela A. Downes, J.D.
                                            Dallas

                                     John R. Huffman, J.D.
                                           Southlake

                                   Leslie D. Rosenstein, Ph.D.
                                              Austin

                                 Texas State Board of Examiners
                                         of Psychologists
                               333 Guadalupe, Tower 2, Suite 2-450
                                      Austin, Texas 78701
                               (512) 305-7700 Fax (512) 305-7701

                                  http://www.tsbep.state.tx.us




August 2012




Texas State Board of Examiners of Psychologists
Jurisprudence Examination Brochure

Page 3 of 3
                      06- Three (3) Reference Letters




Texas State Board of Examiners of Psychologists
Three (3) Reference Letters
TEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS
                                        333 Guadalupe, Ste. 2-450
                                          Austin, Texas 78701
                                             (512) 305-7700

                                         Reference Letter
                                                 for
                              Licensed Specialist in School Psychology

Name and Address of Licensed Psychologist
or Licensed Specialist in School Psychology               After completing and signing this
                                                          reference form, please return it to the
____________________________________                      applicant. This form must be submitted
                                                          by the applicant with the application for
____________________________________                      licensure.

____________________________________

Applicant Name (Please Print):__________________________________________________

The following information is needed before the Texas State Board of Examiners of Psychologists
can consider the applicant's licensure request. Please respond as quickly as possible in order for
the applicant's professional career to be considered without delay. The Public Information Act is
enforced as required by State law. Fax copies of this document cannot be accepted. Please
return this completed form to the applicant.

1.     Do you know the applicant well enough to evaluate him/her? Yes_____ No_____

       a.      If NO, please sign this section and return to the applicant.

               ____________________________             ______________________________
               Your Printed Name                        Your Signature

       b.      If YES, please complete the following about yourself:

               ____________________________             ______________________________
               Your Printed Name                        Your Signature


               Current Address:______________________________________________

               ____________________________________________________________

               ____________________________________________________________

               Telephone:          (______) ______________________________
                                   Area Code

Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 1 of 3
Area of doctoral or master’s level training/education in psychology:

               ____________________________________________________________

               ____________________________________________________________

               ____________________________________________________________

               Current Job Position:__________________________________________

               ____________________________________________________________

               Please give date(s) of your licensure at the time that you knew the applicant. Also
               provide your license no.(s), and name of state(s) where you hold/held licenses to
               practice psychology.

               Date           License No.           State          Current? Yes/No

               _______        _________             _______        ______________

               _______        _________             _______        ______________

               _______        _________             _______        ______________

2.     What was the time period you knew the applicant? (Where possible please give specific
       dates, e.g. from January 1, 1984 to September 15, 1985)

       __________________________________________________________________

3.     In what type of professional setting did you know the applicant? (e.g., private practice,
       university, agency, etc.)

       __________________________________________________________________

4.     What was your professional relationship with the applicant?              (e.g., professor,
       practicum/internship, advisor, supervisor, colleague, etc.)

       __________________________________________________________________

5.     Are you related to the applicant within the second degree of affinity or within the second
       degree by consanguinity?

       Yes__________          No__________


Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 2 of 3
6.       Please list the psychological services you feel the applicant is qualified to provide.
         Describe and evaluate the applicant's professional work experience to the extent that you
         know.

         __________________________________________________________________

         __________________________________________________________________

         __________________________________________________________________
7.       Do you feel the applicant is physically and mentally competent to render psychological
         services as a specialist in school psychology? If NO, please attach letter of explanation.
                Yes_______ No_______

8.       Do you have any reservations concerning the applicant's ethical, professional, or personal
         qualifications for licensure? If YES, please attach letter of explanation.
         Yes_______ No_______




_______________________________________
Date Form Completed by Licensed Psychologist
or Licensed Specialist in School Psychology

Please return this completed form to the applicant.




LSSPREF – August 2006




Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 3 of 3
TEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS
                                        333 Guadalupe, Ste. 2-450
                                          Austin, Texas 78701
                                             (512) 305-7700

                                         Reference Letter
                                                 for
                              Licensed Specialist in School Psychology

Name and Address of Licensed Psychologist
or Licensed Specialist in School Psychology               After completing and signing this
                                                          reference form, please return it to the
____________________________________                      applicant. This form must be submitted
                                                          by the applicant with the application for
____________________________________                      licensure.

____________________________________

Applicant Name (Please Print):__________________________________________________

The following information is needed before the Texas State Board of Examiners of Psychologists
can consider the applicant's licensure request. Please respond as quickly as possible in order for
the applicant's professional career to be considered without delay. The Public Information Act is
enforced as required by State law. Fax copies of this document cannot be accepted. Please
return this completed form to the applicant.

1.     Do you know the applicant well enough to evaluate him/her? Yes_____ No_____

       a.      If NO, please sign this section and return to the applicant.

               ____________________________             ______________________________
               Your Printed Name                        Your Signature

       b.      If YES, please complete the following about yourself:

               ____________________________             ______________________________
               Your Printed Name                        Your Signature


               Current Address:______________________________________________

               ____________________________________________________________

               ____________________________________________________________

               Telephone:          (______) ______________________________
                                   Area Code

Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 1 of 3
Area of doctoral or master’s level training/education in psychology:

               ____________________________________________________________

               ____________________________________________________________

               ____________________________________________________________

               Current Job Position:__________________________________________

               ____________________________________________________________

               Please give date(s) of your licensure at the time that you knew the applicant. Also
               provide your license no.(s), and name of state(s) where you hold/held licenses to
               practice psychology.

               Date           License No.           State          Current? Yes/No

               _______        _________             _______        ______________

               _______        _________             _______        ______________

               _______        _________             _______        ______________

2.     What was the time period you knew the applicant? (Where possible please give specific
       dates, e.g. from January 1, 1984 to September 15, 1985)

       __________________________________________________________________

3.     In what type of professional setting did you know the applicant? (e.g., private practice,
       university, agency, etc.)

       __________________________________________________________________

4.     What was your professional relationship with the applicant?              (e.g., professor,
       practicum/internship, advisor, supervisor, colleague, etc.)

       __________________________________________________________________

5.     Are you related to the applicant within the second degree of affinity or within the second
       degree by consanguinity?

       Yes__________          No__________


Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 2 of 3
6.       Please list the psychological services you feel the applicant is qualified to provide.
         Describe and evaluate the applicant's professional work experience to the extent that you
         know.

         __________________________________________________________________

         __________________________________________________________________

         __________________________________________________________________
7.       Do you feel the applicant is physically and mentally competent to render psychological
         services as a specialist in school psychology? If NO, please attach letter of explanation.
                Yes_______ No_______

8.       Do you have any reservations concerning the applicant's ethical, professional, or personal
         qualifications for licensure? If YES, please attach letter of explanation.
         Yes_______ No_______




_______________________________________
Date Form Completed by Licensed Psychologist
or Licensed Specialist in School Psychology

Please return this completed form to the applicant.




LSSPREF – August 2006




Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 3 of 3
TEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS
                                        333 Guadalupe, Ste. 2-450
                                          Austin, Texas 78701
                                             (512) 305-7700

                                         Reference Letter
                                                 for
                              Licensed Specialist in School Psychology

Name and Address of Licensed Psychologist
or Licensed Specialist in School Psychology               After completing and signing this
                                                          reference form, please return it to the
____________________________________                      applicant. This form must be submitted
                                                          by the applicant with the application for
____________________________________                      licensure.

____________________________________

Applicant Name (Please Print):__________________________________________________

The following information is needed before the Texas State Board of Examiners of Psychologists
can consider the applicant's licensure request. Please respond as quickly as possible in order for
the applicant's professional career to be considered without delay. The Public Information Act is
enforced as required by State law. Fax copies of this document cannot be accepted. Please
return this completed form to the applicant.

1.     Do you know the applicant well enough to evaluate him/her? Yes_____ No_____

       a.      If NO, please sign this section and return to the applicant.

               ____________________________             ______________________________
               Your Printed Name                        Your Signature

       b.      If YES, please complete the following about yourself:

               ____________________________             ______________________________
               Your Printed Name                        Your Signature


               Current Address:______________________________________________

               ____________________________________________________________

               ____________________________________________________________

               Telephone:          (______) ______________________________
                                   Area Code

Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 1 of 3
Area of doctoral or master’s level training/education in psychology:

               ____________________________________________________________

               ____________________________________________________________

               ____________________________________________________________

               Current Job Position:__________________________________________

               ____________________________________________________________

               Please give date(s) of your licensure at the time that you knew the applicant. Also
               provide your license no.(s), and name of state(s) where you hold/held licenses to
               practice psychology.

               Date           License No.           State          Current? Yes/No

               _______        _________             _______        ______________

               _______        _________             _______        ______________

               _______        _________             _______        ______________

2.     What was the time period you knew the applicant? (Where possible please give specific
       dates, e.g. from January 1, 1984 to September 15, 1985)

       __________________________________________________________________

3.     In what type of professional setting did you know the applicant? (e.g., private practice,
       university, agency, etc.)

       __________________________________________________________________

4.     What was your professional relationship with the applicant?              (e.g., professor,
       practicum/internship, advisor, supervisor, colleague, etc.)

       __________________________________________________________________

5.     Are you related to the applicant within the second degree of affinity or within the second
       degree by consanguinity?

       Yes__________          No__________


Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 2 of 3
6.       Please list the psychological services you feel the applicant is qualified to provide.
         Describe and evaluate the applicant's professional work experience to the extent that you
         know.

         __________________________________________________________________

         __________________________________________________________________

         __________________________________________________________________
7.       Do you feel the applicant is physically and mentally competent to render psychological
         services as a specialist in school psychology? If NO, please attach letter of explanation.
                Yes_______ No_______

8.       Do you have any reservations concerning the applicant's ethical, professional, or personal
         qualifications for licensure? If YES, please attach letter of explanation.
         Yes_______ No_______




_______________________________________
Date Form Completed by Licensed Psychologist
or Licensed Specialist in School Psychology

Please return this completed form to the applicant.




LSSPREF – August 2006




Texas State Board of Examiners of Psychologists
Three (3) Reference Letters

Page 3 of 3
                07- Documentation of Experience Form




Texas State Board of Examiners of Psychologists
Documentation of Experience
                TEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS
                               333 Guadalupe, Suite 2-450
                                  Austin, Texas 78701
                                    (512) 305-7700

                                       Reference Letter and
                              Documentation of Supervised Experience
                                                 for
                              Licensed Specialist in School Psychology

Name and Address of Licensed Psychologist or
Licensed Specialist in School Psychology                    After completing and signing this
                                                            reference form, please return it to the
____________________________________                        applicant. This form must be submitted
                                                            by the applicant with the application for
____________________________________                        licensure.

____________________________________

Applicant Name (Please Print):__________________________________________________

The following information is needed before the Texas State Board of Examiners of Psychologists can
consider the applicant's licensure request. Board Rule §463.9 requires that a person have a minimum of
1,200 hours of supervised experience, 600 of which must be in a public school. Please respond as quickly
as possible in order for the applicant's professional career to be considered without delay. The Open
Records Act is enforced as required by State law. Fax copies of this document cannot be accepted.
Please return this form to the applicant.

1.     Do you know the applicant well enough to evaluate him/her? Yes_____ No_____

       a.       If NO, please sign this section and return to the applicant.

               _________________________________             ____________________________________
               Your Printed Name                             Your Signature


       b.       If YES, please complete the following about yourself:

               _________________________________                   _______________________________
               Your Printed Name                                   Your Signature


               Current Address:_________________________________________________________

               _______________________________________________________________________

               _______________________________________________________________________

               Telephone:          (______) _________________________
                                   Area Code


Texas State Board of Examiners of Psychologists
Documentation of Experience

Page 1 of 3
               Your highest degree and area of training/education:______________________________

               _______________________________________________________________________

               How many years of experience have you had practicing psychology in the public
               schools?

               ________________________________________________________________________

               Your Current Job Position:__________________________________________________

               Please give date(s) of your licensure at the time that you supervised the applicant. Also
               provide your license no.(s), and name of state(s) where you hold/held licenses to practice
               psychology.

                       Date            License No.              State           Current? Yes/No

                       _______         _________                _______         ______________

                       _______         _________                _______         ______________

                       _______         _________                _______         ______________

2.     What was your professional relationship with the applicant? (e.g., internship director, employer,
       on-site supervisor, etc.)

       ______________________________________________________________________________

3.     Do you feel the applicant is physically and mentally competent to render psychological services
       as a licensed specialist in school psychology? If NO, please attach letter of explanation.

       Yes_______      No_______

4.     Do you feel the applicant is professionally competent to render psychological services as a
       licensed specialist in school psychology? If NO, please attach letter of explanation.

       Yes_______      No_______

5.     Do you have any reservations concerning the applicant's ethical, professional, or personal
       qualifications for licensure? If YES, please attach letter of explanation.

       Yes_______      No_______

6.     IF YOU PROVIDED PROFESSIONAL SUPERVISION TO THE APPLICANT, PLEASE
       COMPLETE THE FOLLOWING.

       a.      What was the consecutive time period you supervised the applicant? PLEASE BE
               VERY SPECIFIC.        MONTH, DAY AND YEAR ARE IMPORTANT IN
               DOCUMENTING EXPERIENCE.

Texas State Board of Examiners of Psychologists
Documentation of Experience

Page 2 of 3
                 Beginning Date:_____________________            Ending Date:______________________

                 Beginning Date:_____________________            Ending Date:______________________

        b.       How many clock hours per week did the applicant work under your supervision during
                 the above time period?_____________________________________

        c.       How many direct, systematic, face-to-face hours of supervision did you give the applicant
                 every week (or specify if it was every two weeks).

                 ________________________________________________________________________

        d.       At the time of supervision, were you related to the applicant within the second degree of
                 affinity or within the second degree by consanguinity?

                 Yes_______      No_______

        e.       Were you under any disciplinary order from your licensing board at the time of
                 supervision? Yes_______ No_______

        f.       Did the applicant have the background, training, and experience appropriate to the
                 functions performed? Yes_______ No_______

        g.       Did the title used by the applicant while under your supervision clearly indicate his/her
                 supervised status?      Yes_______ No_______

        h.       Were all clients informed that applicant and all aspects of applicant's work were being
                 supervised?     Yes_______ No_______

        i.       Please indicate the type of professional setting where your supervision took
                 place.___________________________________________________

        j.       Do you verify that the applicant received hands-on experience in assessment,
                 intervention, behavior management, and consultation, for children representing a range of
                 ages, populations, and needs sufficient to ensure that the applicant is competent to
                 provide these services unsupervised?   Yes_______ No_______



______________________________________________________
Date Form Completed by Licensed Psychologist or
Licensed Specialist in School Psychology


Please return this completed form to the applicant.

LSSPDOCEXP – May 24, 2010




Texas State Board of Examiners of Psychologists
Documentation of Experience

Page 3 of 3
              08- Types of Licensure: Information Sheet




Texas State Board of Examiners of Psychologists
Types of Licensure Information Sheet
                                  TYPES OF LICENSURE

The Texas State Board of Examiners of Psychologists issues four types of regular licenses,
each of which has different requirements set by the Act and rules. (Note: refer to the Act and
rules for the complete requirements for licensure.)

A.     Licensed Psychologist (Independent Practice)
        Requires prior licensure as a Provisionally Licensed Psychologist (see below)
        Requires two (2) years of supervised experience.
        Requires a doctoral degree in psychology
        Requires the passage of the Oral Examination

B.     Provisionally Licensed Psychologist (Supervision Required)
        Requires a doctoral degree in psychology
        Requires passage of the Examination for Professional Practice in Psychology at the
          doctoral level at 70%.
        Requires passage of the Jurisprudence Examination at 90%

C.     Licensed Psychological Associate (Supervision Required)
        Requires a master’s degree primarily psychological in nature
        Requires passage of the Examination for Professional Practice in Psychology at the
          master’s level at 55%.
        Requires passage of the Jurisprudence Examination at 80%

D.     Licensed Specialist in School Psychology (Independent Practice in Public Schools after
       one year of licensure)
        Requires the completion of a training program in school psychology
          approved/accredited by the American Psychological Association or the National
          Association of School Psychologists or a master’s degree in psychology with
          specified course work.
        Requires passage of the National School Psychology Examination
        Requires passage of the Jurisprudence Examination at 90%

Application Packets:
The Board does not pre-evaluate applications. Therefore, a person who is interested in becoming
licensed with this Board should download the application packet for the type of license that is
appropriate for the person’s education and training from the Board’s website at
www.tsbep.state.tx.us.

The current Act and Rules of the Board are available only in an online version which is available
for free download on the Act and Rules page of the Board’s website.

After reviewing this information and reading the pertinent Act and Rules, applicants with
questions should call the Board office.

Texas State Board of Examiners of Psychologists
Types of Licensure Information Sheet

Page 1 of 2
Licensure by Reciprocity
Texas has reciprocity at the doctoral level with eight states (Arkansas, Kentucky, Louisiana,
Missouri, Nebraska, Nevada, New Hampshire, and Wisconsin) and two Canadian provinces
(Manitoba and Ontario). Licensure as a psychologist by reciprocity requires a reciprocity
psychologist application. An eligible applicant must have 5 years licensure as a psychologist
prior to application for reciprocity.

Licensure for Military Spouses
For persons who (1) hold licensure in other states which have licensing requirements
substantially equivalent to Texas licensure and (2) are spouses of active members of the armed
forces, the Board offers alternative licensing requirements. Refer to Board rule 463.30.


Types of Licensure – June 2012




Texas State Board of Examiners of Psychologists
Types of Licensure Information Sheet

Page 2 of 2
           09- Providers of School Psychological Services:
                         Information Sheet




Texas State Board of Examiners of Psychologists
Providers of School Psychological Services: Information Sheet
                Providers of School Psychological Services in the Public School Districts
                                    (Board rules 463.9 and 465.38)


     TYPE (Permitted Titles)                           DEFINITION                                         SUPERVISION REQUIREMENTS

LSSP, Regular

“Licensed Specialist in School          Meets requirements of Board rule §463.9(a)           With more than one year’s experience, none required. During first
Psychology” or “LSSP.” May not          through (e).                                         year of practice as a licensee, must practice under supervision (unless
be called “psychologist” at any time.                                                        also licensed as a psychologist in Texas). See Board rule
                                                                                             §465.38(4)(iii).     Supervision must be sufficient, given the
                                                                                             supervisee’s level of competency and experience, to ensure quality of
                                                                                             care.

“LSSP Trainee”

Must be clearly designated at all       Individuals who have applied for licensure as a      May provide school psychological services on behalf of public
times as “LSSP Trainee.” May not        regular LSSP and have received notification from     school district to public school students under qualified supervision
be called “psychologist” at any time.   Board that they have met all training requirements   for up to one year while they take and pass the required
                                        and passed the National School Psychology            Jurisprudence examination. After one year, if they have not acquired
                                        examination.                                         the LSSP, or if at any time during the year the application is voided,
                                                                                             ability to practice ends immediately. Patients/clients are the actual
                                                                                             patients/clients of the supervisor. The supervisor is directly
                                                                                             responsible for all services and actions of the trainee. Trainee status
                                                                                             does not qualify trainee to provide psychological services of any
                                                                                             other kind.




Texas State Board of Examiners of Psychologists
Providers of School Psychological Services: Information Sheet

Page 1 of 2
                                Providers of School Psychological Services in the Public School Districts
                                                              Page Two

     TYPE (Permitted Titles)                               DEFINITION                                             SUPERVISION REQUIREMENTS

Intern:

“LSSP Intern”                             Individuals fulfilling internship requirement of          Must be under direct supervision of qualified supervisor at all times
                                          Board rule §463.9(c).                                     that school psychological services are being provided to a public
Must be clearly designated as an                                                                    school student. Internship must be provided through a recognized
“intern” at all times and may not be                                                                training program at regionally accredited university or college unless
referred to as a “psychologist.”                                                                    the internship is pursuant to doctoral level licensure as a
                                                                                                    psychologist. Supervisor is individually responsible for ensuring that
                                                                                                    internship meets all requirements enumerated in Board rule
                                                                                                    §463.9(c).


Intern, student, or trainee not
pursuing LSSP OR pursuing
LSSP simultaneously.
                                          Individuals pursuing a course of study in                 May only practice school psychology in a public school district under
Must be clearly designated as a           preparation for the practice of psychology in a           direct supervision of an individual who is both a licensed
“psychological intern,”                   recognized training institution pursuant to Section       psychologist and a LSSP qualified to supervise and only to the extent
“psychological trainee” or                501.004 of Act and completing a doctoral or post-         the intern is qualified by virtue of experience and training. Once the
“psychological student” at all times      doctoral internship         pursuant to Section           internship ends, the intern may not offer services of any kind in the
and may not be referred to or listed      501.252(b)(2).                                            schools unless the applicant is an LSSP. Patients/clients receiving
as a “psychologist.”                                                                                services are the patients/clients of the supervisor. The supervisor is
                                                                                                    directly responsible for all services and actions performed during the
                                                                                                    course of the intern’s delivery of school psychological services to a
                                                                                                    public school student.


Qualified Supervisor: Supervision of delivery of all school psychological services on behalf of a public school district to a public school student must be provided by an
LSSP with at least three years experience (one of which may have been obtained while under supervision by another qualified supervisor) in a public school district. No
other individual, regardless of training or experience, may provide supervision. See Board rule §465.38(5).

Effective June 30, 1998
Amended 11/10/98; 12/15/99; 4/15/05; 6/1/11

Texas State Board of Examiners of Psychologists
Providers of School Psychological Services: Information Sheet

Page 2 of 2
                                 10- Fee Schedule




Texas State Board of Examiners of Psychologists
Fee Schedule
                                                           FEE SCHEDULE
FEES

§473.1 - §473.5

§473.1              Application Fees (Non-refundable)
                    Psychological Associate Licensure                                                             $190
                    Psychologist Provisional Licensure                                                            $340
                    Licensure                                                                                     $180
                    Reciprocity                                                                                   $480
                    Licensed Specialist in School Psychology                                                      $220

§473.2              Examination Fees (Non-refundable, non-transferable)
                    Examination for the Professional Practice of Psychology                                       $650*
                    Jurisprudence                                                                                 $210
                    Oral Examination                                                                              $320

§473.3              Annual Renewal Fees (Non-refundable)
                    Psychological Associate Licensure                                                             $114
                    Psychological Associate over the age of 70                                                    $ 16
                    Psychologist Provisional Licensure                                                            $309*
                    Psychologist Provisional Licensure over the age of 70                                         $216*
                    Psychologist Licensure                                                                        $405*
                    Psychologist Licensure over the age of 70                                                     $216*
                    HSP Certification                                                                             $ 20
                    Psychologist Health Service Provider Certificand
                             over the age of 70                                                                   No Fee
                    Licensed Specialist in School Psychology                                                      $ 57
                    Licensed Specialist in School Psychology over the age of 70                                   $ 14

§473.4              Late Fees (Non-refundable)
                    Licensed Psychological Associates, Provisionally Licensed
                    Psychologists, Licensed Psychologists
                    One day to ninety days                                                                        $225
                    Ninety-one days to less than one year                                                         $450
                    Licensed Specialists in School Psychology
                    One day to ninety days                                                                        $105
                    Ninety-one days to less than one year                                                         $210

§473.5              Miscellaneous Fees (Non-refundable)
                    Duplicate or Replacement license                                                              $ 25
                    Inactive Status    (2 year period)                                                            $100
                    Remailing of license                                                                          $ 10
                    Returned check fee                                                                            $ 25
                    Returned renewal application fee                                                              $ 10
                    Analysis of Jurisprudence Exam                                                                $ 50
                    Application Packets                                                                           $ 15
                    Cost of destroyed, lost or stolen annual renewal permits                                      $ 10
                    Cost of replacement renewal notice                                                            $ 10
        Includes the $200 professional fee mandated by the Seventy-second Legislature collected by the Psychology Board for deposit in the General
         Revenue Fund ($150) and the Foundation School Fund ($50). Section §501.153 of the Psychologists' Licensing Act requires the $200
         professional fee for applicants taking the EPPP for provisional licensure as a psychologist, provisionally licensed psychologist renewal, and
         licensed psychologist renewal.’



Fees – March 2011


Texas State Board of Examiners of Psychologists
Fee Schedule

Page 1 of 1

				
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