Psychologist Application Information
Cov kws kho mob puas siab puas ntsws yuav tsum xa lawv tus kheej thiab / lossis cov ntawv thov pab pawg ntawm PAVE (Cov Ntawv Thov Kev Pabcuam thiab Kev Pov Hwm rau Kev Sau Npe). Yog tias koj tab tom xa ib daim ntawv thov pab pawg, thov xyuas kom koj xa tsawg kawg ob daim ntawv thov kev ua haujlwm hauv PAVE txhawm rau tsim koj pab pawg.
Daim ntawv tso cai
Ua ntej thov rau Medi-Cal, ua ntej kos lub California Pawg Thawj Saib Xyuas Kev puas siab puas ntsws lub vev xaib kom ntseeg tau tias koj ua tau raws li tag nrho cov cai ntawm daim ntawv tso cai.
Cov ntaub ntawv xav tau
Next, gather the required documents listed below, as applicable, in order to upload them into PAVE as you complete your PAVE application. Please ensure the uploaded documents are legible.
- California Psychologist License
- Daim Ntawv Tso Cai Tsav Tsheb lossis daim npav qhia tawm hauv lub xeev (tso tawm hauv 50 Tebchaws Meskas lossis Cheeb Tsam ntawm Columbia) ntawm tus neeg muab kev pabcuam, lossis tus neeg kos npe rau daim ntawv thov uas muaj txoj cai khi rau tus neeg thov lossis tus neeg muab kev pabcuam. Daim ntawv kos npe yuav tsum yog tus muab kev pabcuam, tshwj tsis yog tus neeg muab kev pabcuam yog lub koomhaum. Yog tias tus kws kho mob yog ib lub tuam txhab thiab daim ntawv thov yuav raug kos npe los ntawm ib tus neeg uas tsis yog tus muab kev pabcuam, thov xa ib daim ntawv theej ntawm ntu ntawm lub tuam txhab txoj cai lij choj uas txheeb xyuas tus neeg kos npe txoj cai rau kev cai lij choj lub koom haum.
- Federal Employer Identification Number (FEIN) los yog Individual Taxpayer Identification Number (ITIN) verification, yog tsis siv tus social security naj npawb, los ntawm kev xa ib daim ntawv tam sim no Internal Revenue Service (IRS) generated. Tsuas yog cov ntaub ntawv lees paub muaj xws li IRS-tsim Tsab Ntawv 147-C, IRS-tsim Daim Ntawv 941 (Tsuas Ua Haujlwm Lub Peb Hlis Federal Tax Return), IRS-tsim Daim Ntawv Foos 8109-C (Daim Coupon Deposit), lossis IRS-tsim Daim Ntawv SS-4 (tsuas yog Daim Ntawv Pom Zoo/Kev Qhia Txog Tus Kheej). Nco tseg: Lub npe raug cai ntawm tus neeg thov lossis tus neeg muab kev pabcuam hauv daim ntawv thov yuav tsum ua raws nraim lub npe ntawm IRS-tsim cov ntaub ntawv; thiab tus neeg thov kev pab yuav tsum yog tus tswv lossis tus tub ceev xwm ntawm lub chaw teev npe hauv daim ntawv IRS. Yog xav paub ntxiv, thov mus ntsib IRS lossis hu rau lawv ntawm (800) 829-4933.
- Daim Ntawv Tso Cai Ua Lag Luam Hauv Zos, Daim Ntawv Pov Thawj Se, thiab Daim Ntawv Tso Cai rau txhua lub nroog thiab/lossis lub nroog uas ua lag luam. Lus Cim: Lub npe thiab chaw nyob ua lag luam ntawm tus neeg thov lossis tus neeg muab kev pab uas nyob rau hauv daim ntawv thov yuav tsum phim lub npe ua lag luam thiab chaw nyob ua lag luam uas nyob rau hauv txhua daim ntawv tso cai thiab daim ntawv tso cai hauv zos. Yog tias tsis tas yuav muaj daim ntawv tso cai ua lag luam, thov xa ib daim ntawv sau los ntawm koj lub nroog/lub nroog hauv zos uas qhia tias koj lub lag luam tsis tas yuav muaj daim ntawv tso cai lossis daim ntawv tso cai. Yog xav paub ntxiv, thov hu rau koj lub chaw ua haujlwm tso cai ua lag luam hauv nroog thiab/lossis mus saib lub vev xaib California State Association of Counties , nyem rau ntawm qhov txuas "California's Counties", thiab xaiv "Counties Web Sites."
- Cov Lus Qhia Txog Lub Npe Lag Luam Cuav (FBNS) uas tau sau tseg/muab luam tawm, daim ntawv pov thawj uas lub nroog uas qhov chaw ua lag luam loj nyob tau muab, yog tias siv lub npe ua lag luam cuav THIAB lub npe ua lag luam txawv ntawm lub npe raug cai ntawm koj daim ntawv thov. Piv txwv li, yog tias muaj ib lub koom haum, txhua lub npe uas tsis yog lub npe koom haum uas tau sau tseg nrog Tus Tuav Ntaub Ntawv ntawm Lub Xeev yuav tsum muaj FBNS. Lus Cim: Lub npe lag luam thiab chaw nyob ua lag luam ntawm tus neeg thov lossis tus neeg muab kev pabcuam rau ntawm daim ntawv thov, txhua daim ntawv tso cai ua lag luam hauv zos, thiab FBNS yuav tsum sib xws. Yog xav paub ntxiv txog lub koom haum hauv nroog uas siv tau cov npe lag luam cuav, thov mus saib lub vev xaib California State Association of Counties , nyem rau ntawm qhov txuas "California's Counties", thiab xaiv "Counties Web Sites."
- Fictitious Name Permit (FNP) issued by the California Board of Psychology, if using a fictitious name for your psychology practice, as defined by the Board. Note: The business name of the applicant or provider on the application, all local business licenses/permits, and the FNP must exactly match. For further information, visit the Board of Psychology website and click on “Laws and Regulations”.
- Daim Ntawv Cog Lus Koom Tes Ua tiav tag nrho, yog tias koj lub lag luam yog kev koom tes. Tej zaum yuav zam tau qhov kev ncua sij hawm ua tiav los ntawm kev qhia seb lub koom haum puas yog General Partnership lossis Limited Partnership thiab xa cov hauv qab no:
a) Rau General Partnership, daim ntawv teev npe ntawm txhua tus neeg koom tes nrog feem pua ntawm kev muaj tswv lossis kev tswj hwm rau txhua tus; lossis
b) Rau Limited Partnership, cov ntaub ntawv qhia txog General Partnership thiab daim ntawv teev npe ntawm txhua tus neeg koom tes nrog feem pua ntawm kev muaj tswv lossis kev tswj hwm rau txhua tus.
Yog xav paub ntxiv txog koj txoj kev koom tes, thov mus saib Secretary of State California Business Portal thiab nias rau ntawm qhov txuas "California Business Search" lossis lwm qhov txuas uas tsim nyog. nyem rau ntawm qhov txuas "California Business Search" lossis lwm qhov txuas uas tsim nyog. - Yog tias koj lub lag luam yog ib lub tuam txhab kev tshaj lij, kev ua haujlwm qeeb yuav raug zam los ntawm kev xa ib daim ntawv luam ntawm Cov Ntaub Ntawv Kev Koom Tes ntawm Lub Xeev, thiab cov npe ntawm cov thawj coj thiab cov tub ceev xwm cov npe thiab cov npe, nrog rau feem pua ntawm cov tswv cuab thiab tswj kev txaus siab rau txhua. Txhawm rau txheeb xyuas lossis hloov lub npe thiab / lossis xwm txheej ntawm koj lub tuam txhab lossis xav paub ntxiv, thov mus saib Tus Tuav Ntaub Ntawv ntawm Xeev California Kev Lag Luam Portal thiab nyem rau ntawm "California Lag Luam Tshawb Fawb" txuas lossis lwm qhov txuas uas tsim nyog.
- Certificate of Commercial Liability Insurance (kev lag luam, kev lag luam, lossis kev lav phib xaub, lossis kev tuav pov hwm hauv chaw ua haujlwm) hauv tus nqi tsis pub tsawg dua $ 100,000 rau ib daim ntawv thov thiab qhov tsawg kawg nkaus txhua xyoo ntawm $ 300,000. Kev lees paub lees paub yog pov thawj ntawm kev tuav pov hwm tus kheej, lossis daim ntawv pov thawj ntawm kev tuav pov hwm lossis daim ntawv tshaj tawm uas muab los ntawm lub tuam txhab pov hwm uas muaj lub npe ntawm lub tuam txhab pov hwm, lub npe thiab chaw nyob ua lag luam ntawm cov ntawv pov hwm, hnub siv tau, thiab kev txwv ntawm kev pov hwm. Nco tseg: Lub npe thiab chaw nyob ua lag luam, suav nrog tus lej suite yog tias tsim nyog, ntawm tus neeg thov lossis tus neeg muab kev pabcuam hauv daim ntawv thov yuav tsum ua raws nraim li tus neeg tuav pov hwm lub npe thiab chaw nyob ntawm daim ntawv pov thawj ntawm kev tuav pov hwm lossis daim ntawv tshaj tawm.
- Certificate of Professional Liability Insurance nyob rau hauv ib tug npaum li cas ntawm tsis tsawg tshaj li $100,000 ib daim ntawv thov thiab ib tug yam tsawg kawg nkaus txhua xyoo ntawm $300,000. Kev lees paub lees paub yog daim ntawv pov thawj ntawm kev tuav pov hwm lossis daim ntawv tshaj tawm uas muab los ntawm lub tuam txhab pov hwm uas muaj lub npe ntawm lub tuam txhab pov hwm, lub npe ntawm cov ntawv pov hwm, hnub siv tau, thiab kev txwv ntawm kev pov hwm. Nco tseg: Tus kws kho mob lub npe, raws li nws tshwm nyob rau hauv California Psychologist License, yuav tsum tau qhia nyob rau hauv kev txheeb xyuas ntawm kev pov hwm kev lav phib xaub.
- Certificate of Workers 'Compensation Insurance yog xav tau los ntawm California txoj cai lij choj, yog tias koj lub lag luam muaj ib lossis ntau tus neeg ua haujlwm. Kev lees paub lees paub yog pov thawj ntawm kev tuav pov hwm tus kheej, lossis daim ntawv pov thawj ntawm kev tuav pov hwm lossis daim ntawv tshaj tawm uas muab los ntawm lub tuam txhab pov hwm uas muaj lub npe ntawm lub tuam txhab pov hwm, lub npe thiab chaw nyob ua lag luam ntawm cov ntawv pov hwm, thiab hnub siv tau. Yog tias tsis muaj kev pov hwm them nyiaj rau Cov Neeg Ua Haujlwm, yuav tsum muaj lus piav qhia. Nco tseg: Lub npe thiab chaw nyob ua lag luam ntawm tus neeg thov lossis tus neeg muab kev pabcuam yuav tsum ua raws nraim li cov ntawv pov hwm lub npe thiab chaw nyob ntawm daim ntawv pov thawj ntawm kev pov hwm.
- Kos Npe Daim Ntawv Pom Zoo, yog tias thaj chaw lag luam tsis yog los ntawm tus neeg thov lossis tus muab kev pabcuam. Nco tseg: Lub npe thiab chaw nyob ua lag luam ntawm tus neeg thov lossis tus neeg muab kev pabcuam yuav tsum ua raws nraim li tus neeg xauj tsev lub npe thiab chaw nyob ntawm daim ntawv cog lus xauj tsev.
- Successor Liability with Joint and Several Liability Agreement (DHCS 6217), yog muaj.
TUAJ RAU PAVE