MARYLAND BOARD OF EXAMINERS OF PSYCHOLOGISTS
4201 Patterson Avenue * Baltimore, MD 21215-2299
TEMPORARY EXCEPTION TO PRACTICE APPLICATION
APPLICATION FEE - $100.00 (NON-REFUNDABLE)
This application is to be used during the COVID -19 pandemic by psychologists who are not licensed in Maryland.
Psychologists must hold an active and in good standing license in another jurisdiction and want to provide services
to their client who is temporarily residing in Maryland due to the pandemic. The application asks for the exception
date/s; however, the Board reserves the right to determine the length of time of the exception. If the client does not
plan to return to the jurisdiction where you are licensed, you will need to apply for a Maryland license to continue
serving that client. If you wish to provide services to NEW clients, you will need to apply for a Maryland license.
The application for licensure as well as Maryland laws and regulations are at
R LEGIBLY PRINT (except for signature) the application. Be sure to provide an email address. All
correspondences from the Board will be by email. All questions on the form MUST be answered. Mail your
completed application, the $100.00 application fee payable to the Board of Psychology, and a copy of your active
psychology license from another jurisdiction (faxes and emails will not be accepted). We will not review
1. Full Name: Degree:
2. Home Mailing Address: Telephone:
3. Business Name and Address: Telephone:
4. Preferred Mailing Address: Home
5. Indicate where you hold an active psychology license. Provide proof that your license is in good
standing and there is no pending disciplinary action against your license.
State: License Expiration Date: License #:
6. Have you previously applied for a license to practice psychology in Maryland?
7. Have you ever had a professional license or permit disciplined in any way (e.g., denied, suspended,
reprimanded, censured, restricted, limited, placed on probation, revoked, etc.) by any licensing board
in Maryland or elsewhere, or are you aware of any pending charges or investigations against a
professional license or permit which you hold?
No if yes, provide details on an
Social Security No: