868 IAC 1.1-3-8 Limited scope temporary psychology permit Authority: IC 25-33-1-4.5 Authority: IC 25-1-9; IC 25-33-1-3; IC 25-33-1-9 Sec. 8. (a) A person: (1) not currently licensed to practice psychology in Indiana; (2) licensed to practice psychology without supervision by any board or licensing agency of any other state or jurisdiction; and (3) eligible for licensure under IC 25-33-1-9; may apply to the board for a limited scope temporary psychology permit that, if issued under this section, shall remain valid for a nonrenewable period not to exceed a total of thirty (30) days in any two (2) year period. (b) A person seeking a limited scope temporary psychology permit under this section shall do the following: (1) Complete an application form supplied by the board specifying the following: (A) The reasons for seeking a limited scope temporary psychology permit. (B) The type, extent, and specialization of psychological services that the applicant intends to, or may, provide. (C) The applicant's: (i) residence and office addresses and telephone numbers; (ii) e-mail address; and (D) Statements regarding the psychologist's disciplinary history and fitness to practice. (2) Submit, with the application for a limited scope temporary psychology permit, the following: (A) One (1) recent passport-type photograph of the applicant, taken within eight (8) weeks prior to filing the application. (B) Proof of holding a current and valid unrestricted license to practice psychology without supervision in another state or jurisdiction.(C) The fee for a temporary permit to practice psychology required by 868 IAC 1.1-12-1. (c) All information on the application shall be submitted under oath or affirmation, subject to penalties for perjury.
- Indiana Professional Licensing Agency~Indiana State Psychology Board (3172342051)