License Renewal Acknowledgement
Please read carefully, before proceeding to the application at the bottom:
INSTRUCTIONS AND IMPORTANT INFORMATION
Allow 30 days for processing. Renew online for faster processing. Once your application has been approved, your license status will be updated in the BreEZe online system and you will receive confirmation in the mail.
To avoid delays, print and carefully follow these instructions as you complete the License Renewal Application. A complete renewal application and the correct fee are required for your expiration date to be updated. The Board will mail you a courtesy deficiency notice in the event of an incomplete application or underpayment.
Do not assume your license has been renewed until you verify your license status through the online License Look-Up
Do not mail your application more than 90 days prior to your expiration date.
RECEIPT OF APPLICATION:
To confirm receipt, mail your application using a method that includes tracking.
Make your check payable to “Behavioral Sciences Fund.”
|LICENSE TYPE||Active Renewal||Inactive Renewal|
RENEWAL POSTMARKED AFTER EXPIRATION DATE:
If your renewal form / fee are postmarked after your license’s expiration date, a delinquency fee is required. There is no grace period.
If you have a name change that you would like processed with your renewal application, you must submit the Notification of Name Change form and all required documentation. Your renewal will not be processed until your name change has been processed. Do not send original documents unless specifically requested to do so.
The address you enter on this application is public information and will be placed on the internet pursuant to Business and Professions Code Section 27. If you do not want your home or work address available to the public, provide an alternate mailing address. All correspondence from the Board will be mailed to this address.
CONVICTION OR DISCIPLINE:
Check the box next to "YES" if, since your last renewal, you have had any license (“license” includes registrations, certificates, or other means to engage in practice) disciplined by a government agency, or you have been convicted of, plead guilty to, or pled nolo contendere to any misdemeanor or felony in the United States, its territories, or a foreign country.
Convictions dismissed under sections 1203.4, 1203.4a, or 1203.41 of the Penal Code (or equivalent non-California law) must be disclosed. If you have obtained a dismissal of such a conviction, submit a certified copy of the court order.
Do not include:
- Offenses prior to your 18th birthday
- Charges dismissed under section 1000.3 of the Penal Code
- Convictions under sections 11357(b), (c), (d), (e) or section 11360(b) of the Health and Safety Code which are two (2) years or older
- Traffic violations for which a fine of $500 or less was imposed
“Discipline" includes, but is not limited to, suspension, revocation, voluntary surrender, probation or any other restriction. "License" includes professional registrations, certificates, or other means to engage in practice. It is not necessary to report disciplinary action taken by the California Board of Behavioral Sciences.
The continuing education (CE) hours listed below are required to renew your license with an “active” status:
- 18 hours are required to renew an initial license
- 36 hours are required to renew a license for each two-year renewal period
DO NOT SUBMIT CE CERTIFICATES WITH RENEWAL
INACTIVE OR RETIRED STATUS OPTIONS
If you are not practicing, you have the option to place your license on “inactive” or “retired” status. A holder of an inactive or retired license may not engage in any activity for which an active license is required, including the following:
- You may not provide psychotherapy while your license is inactive or retired, unless you are working in an exempt setting.
- You may not supervise or sign off experience hours while your license is inactive or retired.
- You are not entitled to payment by a client, insurer or other third-party payor for services performed while your license is inactive or retired.
To obtain an inactive license, you must:
- Submit a complete renewal application
- Mark the “Inactive Renewal” box
- Submit the inactive renewal fee
An inactive license must be renewed every two years. There is no penalty for having an inactive status, you can renew with an inactive status indefinitely, and no CE is required to renew. An inactive license can be reactivated at any time by submitting an Inactive to Active License Status Change application, completing the CE required at the time of reactivation, and paying the remainder of the renewal fee.
To obtain a retired license, you must:
- Meet all outstanding requirements for renewal
- Submit a Retired License Application
A retired license never has to be renewed. A licensee approved for retired status may only return to active status for up to three (3) years. To return to active status, a retired licensee must complete CE, obtain fingerprint clearance, and submit a Retired to Active License Status Change application and fee. A licensee retired for three (3) years or longer is not eligible for reactivation. After three (3) years, a new license may only be obtained by applying for licensure and taking the required exams.
You must retain your CE certificates for at least two years from the date of the license renewal for which the courses were completed. The board performs random audits. If you are audited, you must provide copies of your CE certificates at that time.
DISPLAY OF LICENSE:
A licensee is required to display their license in a conspicuous place in their primary place of business.
- A license that is not renewed by the expiration date is deemed expired. It is illegal to practice on an expired license unless you are working in an exempt setting.
- A licensee may not supervise or sign off experience hours while your license is expired.
- A licensee is not entitled to payment by a client, insurer, or other third-party payor for services performed while a license is expired.
LICENSE CANCELLATION AFTER 3 YEARS:
A license that is not renewed within three (3) years after its expiration date will be cancelled. To be licensed again, you will be required to reapply for a new license, meet all current requirements, and pass the licensing examinations.
- For questions about renewal: email firstname.lastname@example.org
- For questions about CE: email email@example.com
I have read and understand the above instructions and information.