Applications and Forms
Psych Corporate Fictitious Name
To download a paper application, click on the license type you wish to apply for:
Application Form for Sponsor/Provider Approval for National and Regional Associations (PDF)
(for EXPIRED or INACTIVE licenses)The reactivation application has been moved to an online process. To review the requirements and submit your reactivation application online login to your account at www.pals.pa.gov and click the pencil icon next to your license number to start the reactivation process.