2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record. To apply for a predetermination, please fill out
Form #3085 and submit all required documentation specified on the form. Pursuant to
Wis. Stat. §
111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.
Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee. Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website at https://aspe.hhs.gov/poverty-guidelines, prior to submitting Form 3217.
Wis. Stat. § 440.08 (2), the required renewal date for the Psychologist credential is 09/30/odd years. Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.
Methods of Application (See application Form 634 for grid of requirements for each method.)
Pre-Credential Education Information
Applicant must have graduated from a regionally accredited institution with a doctoral degree in psychology.
Complete supervised experience.
- One year of supervised experience following conferral of the doctoral degree.
- The person supervising the applicant must have a psychologist license. See Psy 2.09(3), Wis. Stats., for a more complete description of supervised experience requirements.
Application for Licensure
634||Application for License to Practice Psychology|
|3217||Application for Fee Reduction (If applying for a fee reduction, this form must accompany Form 634.)|
2829||Malpractice Suits or Claims Form (if applicable)|
2555||Verification of the Supervised Practice of Psychology|
|1634||Interim Psychologist License Request (Detailed information contained within form.)|
3085||Application for Predetermination|
2252||Convictions and Pending Charges|
3071||Fax Payment Form|