1. (a) To be certified as a health services provider psychologist provisional (HSP-PP), a licensed psychologist holding provisional North Carolina licensure shall be qualified by education. An applicant shall submit a completed, notarized application form and provide documentation of meeting health services provider requirements.

2. (b) The application form shall include the following information:

   1. (1) applicant's name;
   2. (2) mailing address;
   3. (3) email address;
   4. (4) telephone number;
   5. (5) license number; and
   6. (6) health services provider certification level.
3. (c) An applicant shall demonstrate that he or she is qualified by education to provide health services by meeting one of the criteria defined in Rule .2704(b) of this Section.

History Note: Authority G.S. 90-270.143; 90-270.153(d);
Temporary Adoption Eff. December 19, 1994 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;
RRC Objection due to lack of statutory authority Eff. May 18, 1995;
Eff. June 21, 1995;
Amended Eff. January 1, 1996;
Readopted Eff. April 1, 2020.