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This version of the form is not currently in use and is provided for reference only. Download this version of
Psychologist Form 5A
for the current year.
Psychologist Form 5A Application for Limited Permit for Persons Gaining Experience for Licensure - New York
What Is Psychologist Form 5A?
This is a legal form that was released by the New York State Education Department - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 5A?
A: Form 5A is an application for a limited permit for persons gaining experience for licensure as a psychologist in New York.
Q: Who needs to fill out Form 5A?
A: Form 5A must be filled out by individuals who are gaining experience towards becoming a licensed psychologist in New York.
Q: What is a limited permit?
A: A limited permit allows individuals to practice psychology under the supervision of a licensed psychologist while gaining the necessary experience for licensure.
Q: What information is required on Form 5A?
A: Form 5A requires personal information, education and training history, and a statement of the kind of experience you wish to gain.
Form Details:
- Released on April 1, 2021;
- The latest edition provided by the New York State Education Department;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Psychologist Form 5A by clicking the link below or browse more documents and templates provided by the New York State Education Department.
Download Psychologist Form 5A Application for Limited Permit for Persons Gaining Experience for Licensure - New York
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