Note: Forms must include a cover letter with each submission. Incomplete submissions will not be processed by the Board nor will the incomplete submission be returned to you.
We accept credit card payments. Payment information is included on the form.
Charge: $100.00 for a mailing list of active licensed Psychologists and Psychological Examiners in Arkansas.
The mailing list will be in Excel and will consist of the following for active and voluntary inactive licensees:
| License Type | Address | High Degree |
| Abbreviation | City | Supervise Date |
| License Number | State | Spoken Language |
| License Status | Zip | Sign Languages |
| Title | Work Phone |
| First Name | E-Mail |
| Middle Name | License Began |
| Last Name | License Expires |