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OutofState Practitioner Reporting Form Virginia Code 54.12408.4, enacted by Chapter 464 of the 2022 Acts of Assembly, permits health care practitioners licensed, certified, or registered in another
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How to fill out wwwdhpvirginiagovspsychologyout-of-state temporary practitioner reporting

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How to fill out wwwdhpvirginiagovformspsychologyout-of-state temporary practitioner reporting

01
Visit the website www.dhp.virginia.gov/forms/psychology/out-of-state temporary practitioner reporting
02
Download the temporary practitioner reporting form
03
Fill out the form with the required information
04
Provide your personal details such as name, address, and contact information
05
Indicate your current state of licensure and the reason for practicing temporarily in Virginia
06
Provide information about your education, training, and any previous licenses held
07
Attach any supporting documents or statements as required
08
Review the completed form to ensure accuracy and completeness
09
Sign and date the form
10
Submit the form by mail or through the online submission portal as instructed

Who needs wwwdhpvirginiagovformspsychologyout-of-state temporary practitioner reporting?

01
Psychologists from out-of-state who want to practice temporarily in Virginia need to submit the www.dhp.virginia.gov/forms/psychology/out-of-state temporary practitioner reporting.

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The www.dhp.virginia.gov/forms/psychology/out-of-state temporary practitioner reporting is a form used to report information about psychology practitioners who are working temporarily in Virginia but are licensed in another state.
Psychology practitioners who are licensed in another state and are working temporarily in Virginia are required to file the www.dhp.virginia.gov/forms/psychology/out-of-state temporary practitioner reporting.
To fill out the www.dhp.virginia.gov/forms/psychology/out-of-state temporary practitioner reporting, practitioners need to provide information about their licensing state, temporary practice location in Virginia, duration of temporary practice, and other relevant details.
The purpose of www.dhp.virginia.gov/forms/psychology/out-of-state temporary practitioner reporting is to ensure that psychology practitioners working temporarily in Virginia from out-of-state meet the necessary requirements and regulations.
Information such as licensing state, temporary practice location in Virginia, duration of temporary practice, contact information, and other relevant details must be reported on www.dhp.virginia.gov/forms/psychology/out-of-state temporary practitioner reporting.
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