1. (a) No re-application for a revoked license will be considered for a period of 5 years following the revocation.

2. (b) Re-application after license is revoked for administrative action shall include the following documents:

   1. (1) Application form,
   2. (2) Official transcripts, mailed from the university,
   3. (3) Document of recommendation forms,
   4. (4) Supervision Agreement,
   5. (5) Statement of Professional Disclosure,
   6. (6) New Application Fee,
   7. (7) On-Site Supervisor Verification Form, and
   8. (8) Two (2) classifiable sets of fingerprints.

3. (c) Applicant shall re-take two examinations:

   1. (1) The Practitioner's Examination of Psychological Knowledge or another equivalent examination as determined by the Department; and
   2. (2) The LBP State Standards Test.
4. (d) Internship Documentation Form on file may carry over to a new application.
5. (e) All previously submitted and approved Supervised Experience shall not carry over to a new application.
6. (f) At the time of application, applicant must provide additional documentation to demonstrate rehabilitation relating to the cause of revocation.
7. (g) The Department may impose reasonable practice limitations that are in addition to the requirements for completion of approved supervised experience.
8. (h) Application materials shall be reviewed by the LBP Advisory Board for approval.

Transferred from 310:403-11-8 by Laws 2013, c. 229, § 3(F), eff 11-1-13 (see Editor's Note at beginning of this Chapter)