PSYCHOLOGIST EXAMINERS RULES AND REGULATIONS

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Code of Colorado Regulations › 700 Department of Regulatory Agencies › 721 Division of Professions and Occupations - Board of Psychologists Examiners › 3 CCR 721-1

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Department of Regulatory Agencies

State Board of Psychologists Examiners

PSYCHOLOGIST EXAMINERS RULES AND REGULATIONS

3 CCR 721-1

[Editor’s Notes follow the text of the rules at the end of this CCR Document.]

AUTHORITY

These Rules are promulgated pursuant to sections 12-20-204(1), 12-245-204(4)(a) and

12-245-222(2), C.R.S.

The licensing and regulation of Mental Health Professionals is found in Title 12

(“Professions and Occupations”), Article 245 (“Mental Health”) of the Colorado Revised

Statutes (“Mental Health Practice Act”). Article 245 consists of eight parts summarized,

as applicable, as follows:

Part

Name of Part

Statutes in Part

Part 1

Legislative Declaration

12-245-101

Part 2

General Provisions

12-245-202 - 12-245-

234

Part 3

Psychologists

12-245-301 - 12-245-

306

Part 2 contains general provisions applicable to all Mental Health Professionals. Part 3

applies specifically to psychologists.

PURPOSE AND SCOPE

These Rules were promulgated in order to carry out the powers and duties of the State

Board of Psychologist Examiners pursuant to sections 12-20-204(1), 12-245-204 and

12-245-302, C.R.S. These Rules affect every person seeking Colorado licensure as a

psychologist and every person who practices as a licensed psychologist in the State of

Colorado, and who is not statutorily exempted.

1.1

DEFINITIONS

In addition to the definitions set out in sections 12-245-202 and 12-245-301, C.R.S.,

unless the context requires otherwise, as used in these Rules:

“The Board” means the State Board of Psychologist Examiners established

pursuant to section 12-245-302, C.R.S.

“Director” means the Board's Program Director and staff.

Code of Colorado Regulations

Secretary of State

State of Colorado

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245-301, C.R.S.,

unless the context requires otherwise, as used in these Rules:

“The Board” means the State Board of Psychologist Examiners established

pursuant to section 12-245-302, C.R.S.

“Director” means the Board's Program Director and staff.

Code of Colorado Regulations

Secretary of State

State of Colorado

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“Employment counseling” means professional activities that are provided on a

short-term basis and that are intended to assist individuals with locating, applying

for, interviewing, or otherwise successfully securing paid employment.

“License in good standing” means a license that is not restricted in any manner.

“Licensee” as contemplated under section 12-245-225(2), C.R.S., shall include

any person who has been licensed as a psychologist or a psychologist candidate

at any time under the Mental Health Practice Act pursuant to section 12-245-301,

et seq., C.R.S.

“Rehabilitation counseling” means professional activities that are intended to

assist a person with a physical handicap, defect, or injury as defined in sections

26-8-105(2)(a), (b), or (c), C.R.S., to learn or to relearn to perform routine daily

functions including, but not limited to, eating, dressing, transportation, or

employment.

1.2

PUBLIC PARTICIPATION AT BOARD MEETINGS (C.R.S. §§ 12-20-204(1), 12-

245-204, 12-245-222)

The Board may provide a person a reasonable opportunity to address the Board

at an open meeting if the request is made prior to the meeting in accordance with

this Rule and, in the Board's sole discretion, the granting of the request will not

result in delay or disruption of the Board's meeting.

Except in unusual circumstances and in the Board's sole discretion, the Board

will rely exclusively on written materials during its initial consideration of inquiries

and shall not permit members of the public to address the Board on pending

disciplinary proceedings or cases.

he Board's sole discretion, the granting of the request will not

result in delay or disruption of the Board's meeting.

Except in unusual circumstances and in the Board's sole discretion, the Board

will rely exclusively on written materials during its initial consideration of inquiries

and shall not permit members of the public to address the Board on pending

disciplinary proceedings or cases.

The Board Chair may impose reasonable limitations on the time allotted for

comments made pursuant to this Rule.

1.3

CONFIDENTIALITY OF PROCEEDINGS AND RECORDS OF THE BOARD

(C.R.S. §§ 12-245-220, 12-245-222, 12-245-226(4))

General. Inquiries, complaints, investigations, hearings, meetings, or any other

proceedings of the Board relating to disciplinary proceedings shall not be open to

public inspection until the Board meets for its initial consideration of the inquiry

that gave rise to the proceedings. The initial consideration of the inquiry and all

further proceedings shall be open and the records available for inspection unless

subsection (B) of this Rule, or an exception to the Public Records Act or the

Open Meetings Act applies or section 12-245-226(4), C.R.S., prohibits

disclosure.

Subpoenaed Information. Information subpoenaed by the Board shall remain

confidential and not be open to public inspection until the Board has reviewed the

information and made a determination whether the information should remain

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the

Open Meetings Act applies or section 12-245-226(4), C.R.S., prohibits

disclosure.

Subpoenaed Information. Information subpoenaed by the Board shall remain

confidential and not be open to public inspection until the Board has reviewed the

information and made a determination whether the information should remain

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confidential. Information which is not determined to be confidential shall be open

to public inspection unless an exception to subsection (a) an exception to the

Public Records Act or the Open Meetings Act applies or section 12-245-226(4),

C.R.S., prohibits disclosure. This exception shall not apply to review of

information by a respondent in a Board investigation.

1.4

DECLARATORY ORDERS (C.R.S. § 24-4-105(11))

Any person may petition the Board for a declaratory order to terminate a

controversy or to remove uncertainty as to the applicability to the petitioner of any

statutory provision or of any Board Rule or Order.

A petition filed pursuant to this Rule shall set forth the following:

The name and address of the petitioner and whether the petitioner is a

Licensee.

The statute, rule, or order to which the petition relates.

A concise statement of all facts necessary to show the nature of the

controversy or uncertainty and the manner in which the statute, rule, or

order in question applies or potentially applies to the petitioner.

The Board will determine, in its discretion and without notice to petitioner,

whether to rule on a petition. In determining whether to rule on a petition, the

Board will consider the following matters, among others:

Whether a ruling on the petition will terminate a controversy or remove

uncertainty as to the applicability to petitioner of any statutory provision or

Board Rule or Order.

er.

The Board will determine, in its discretion and without notice to petitioner,

whether to rule on a petition. In determining whether to rule on a petition, the

Board will consider the following matters, among others:

Whether a ruling on the petition will terminate a controversy or remove

uncertainty as to the applicability to petitioner of any statutory provision or

Board Rule or Order.

Whether the petition involves any subject, question, or issue that is the

subject of a formal or informal matter, proceeding, or investigation

involving the petitioner and currently pending before the Board, any other

agency, or a court.

Whether the petition involves any subject, question, or issue that is the

subject of a formal or informal matter, proceeding, or investigation

currently pending before the Board, any other agency, or a court, but not

involving the petitioner.

Whether the petition seeks a ruling on a moot or hypothetical question or

will result in an advisory ruling or opinion.

Whether the petitioner has some other adequate legal remedy, other than

an action for declaratory relief pursuant to Rule 57, Colorado Rules of Civil

Procedure, that will terminate the controversy or remove any uncertainty

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as to the applicability to the petitioner of the statute, rule, or order in

question.

If the Board determines, in its discretion, that it will not rule on the petition

pursuant to this Rule, the Board shall promptly notify the petitioner of its action

and state the reasons for such action.

If the Board determines, in its discretion, that it will rule on the petition, any ruling

of the Board will apply only to the facts presented in the petition and any

amendment to the petition. If the Board rules on the petition without a hearing, it

shall notify the petitioner of its decision within 120 days.

In ruling on the petition, the Board may take one or more of the following actions,

in its discretion:

termines, in its discretion, that it will rule on the petition, any ruling

of the Board will apply only to the facts presented in the petition and any

amendment to the petition. If the Board rules on the petition without a hearing, it

shall notify the petitioner of its decision within 120 days.

In ruling on the petition, the Board may take one or more of the following actions,

in its discretion:

The Board may dispose of the petition on the basis of the matters set out

in the petition.

The Board may request the petitioner to submit additional facts, in writing.

In this event, the additional facts amend the petition.

The Board may order the petitioner to file a written brief, memorandum, or

statement of position.

The Board may set the petition for hearing, upon due notice to petitioner,

to obtain additional facts or information; to determine the truth of any facts

set forth in the petition; or to hear oral argument on the petition. The notice

to the petitioner setting the hearing shall state, to the extent known, the

factual or other matters into which the Board intends to inquire. For the

purpose of the hearing, to the extent necessary, the petitioner shall have

the burden of proving all facts stated in the petition; all facts necessary to

show the nature of the controversy or uncertainty; the manner in which the

statute, rule, or order in question applies or potentially applies to the

petitioner; and any other facts the petitioner desires the Board to consider.

If the Board determines that the petition addresses a matter within the purview of

any other agency, the Board shall refer the petition to the other agency for

consideration. If the Board refers a petition to another agency, the Board shall

promptly inform the petitioner of the referral. The referral ends the matter before

the Board.

The parties to any proceeding pursuant to this Rule shall be the Board and the

petitioner. Any other person may seek leave of the Board to intervene in such a

proceeding

rd shall refer the petition to the other agency for

consideration. If the Board refers a petition to another agency, the Board shall

promptly inform the petitioner of the referral. The referral ends the matter before

the Board.

The parties to any proceeding pursuant to this Rule shall be the Board and the

petitioner. Any other person may seek leave of the Board to intervene in such a

proceeding. A petition to intervene shall set forth the matters required by

subsection (c) of this Rule. Based on the information presented and in its

discretion, the Board may grant leave to intervene. Any reference to “petitioner”

in this Rule includes any person who has been granted leave to intervene by the

Board.

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Any declaratory order or other order disposing of a petition pursuant to this Rule

shall constitute final agency action subject to judicial review pursuant to section

24-4-106, C.R.S.

1.5

MANDATORY DISCLOSURE STATEMENT (C.R.S. §§ 12-245-216, 12-245-

224(1)(p))

As used in section 12-245-216, C.R.S., and this Rule,

If the recipient of psychotherapy or mental health services is an adult for

whom a guardian or legal representative has been appointed by a court of

competent jurisdiction (irrespective of an appeal of the order) because the

adult is an “incapacitated person” within the meaning of section 15-14-

101(1), C.R.S., the mandatory disclosure is made to the guardian or legal

representative.

“Emergency” means those situations in which, on presentation, the client's

condition requires immediate intervention and/or stabilization.

1.6

INFORMATION REQUIRED TO BE REPORTED TO THE BOARD (C.R.S. § 12-

245-226(8))

General

se the

adult is an “incapacitated person” within the meaning of section 15-14-

101(1), C.R.S., the mandatory disclosure is made to the guardian or legal

representative.

“Emergency” means those situations in which, on presentation, the client's

condition requires immediate intervention and/or stabilization.

1.6

INFORMATION REQUIRED TO BE REPORTED TO THE BOARD (C.R.S. § 12-

245-226(8))

General. Psychologists are required to report violations of sections 12-245-224

and/or 12-245-228, C.R.S., to the appropriate Board once they have direct

knowledge that a licensee as defined by section 12-245-202(8), C.R.S., a

certificate holder as defined by section 12-245-202(2), or a registrant as defined

by section 12-245-202(16), C.R.S., has violated a provision of section 12-245-

224 or 12-245-228, C.R.S., to include conversion therapy with a client under the

age of 18 years old prohibited per section 12-245-224(1)(t)(V), C.R.S.

Psychologists are not required to report when reporting would violate

client/therapist confidentiality (refer to section 12-245-220, C.R.S.).

Terms.

“Direct knowledge” includes, but is not limited to the following

Having seen, heard, or participated in the alleged violation;

Having been informed by the client/victim and obtained informed

consent to release information as to the event or the client's name;

Having been informed of a violation by the violator;

Having been informed by a guardian of a minor or adult and

obtained informed consent from the guardian to release

information; or

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ving been informed by the client/victim and obtained informed

consent to release information as to the event or the client's name;

Having been informed of a violation by the violator;

Having been informed by a guardian of a minor or adult and

obtained informed consent from the guardian to release

information; or

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Having been informed by a professional organization, agency, or

any other entity, that an alleged violation occurred.

“Has violated” means a reasonable belief that a Licensee, certified

addiction counselor, or unlicensed psychotherapist has engaged in a

prohibited activity under section 12-245-224, C.R.S., or the unauthorized

practice as prohibited under section 12-245-228, C.R.S.

Procedures.

Once direct knowledge is established, the psychologist must report the

alleged violation as soon as possible or, absent unusual circumstances,

no later than sixty (60) days.

When direct knowledge of a violation of section 12-245-224 or 12-245-

228, C.R.S., is obtained from their client, the psychologist shall:

Inform the client a violation may have occurred;

Encourage the client to report the violation; and

Obtain the client's informed consent before reporting the alleged

violation.

The report shall be in writing and shall include the specifics of the

violation, to the degree known, and any and all relevant information and

supporting documentation.

Nothing in this Rule relieves any mental health professional from adhering to any

other mandatory reporting requirements mandated by statute.

1.7

SUPERVISION OF MENTAL HEALTH PRACTITIONERS AND SUPERVISORY

RELATIONSHIPS (C.R.S. §§ 12-245-222(2), 12-245-224(1)(n))

General. Supervision provides a source of knowledge, expertise, and more

advanced skills to the person being supervised. The nature of this relationship

depends on the respective skills of the two professionals involved, the client

population and/or the specific client being served

PERVISION OF MENTAL HEALTH PRACTITIONERS AND SUPERVISORY

RELATIONSHIPS (C.R.S. §§ 12-245-222(2), 12-245-224(1)(n))

General. Supervision provides a source of knowledge, expertise, and more

advanced skills to the person being supervised. The nature of this relationship

depends on the respective skills of the two professionals involved, the client

population and/or the specific client being served. It is usually ongoing, required,

and hierarchical in nature. This Rule does not apply to the supervision required

prior to licensure as a psychologist.

Terms.

Clinical supervision occurs when there is close, ongoing review and

direction of a supervisee's clinical practice.

Consultation describes a voluntary relationship between professionals of

relative equal expertise or status wherein the consultant offers their best

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advice or information on an individual case or problem for use by the

consultee as they deem appropriate in their professional judgment.

Administrative supervisor is the person who bears responsibility for the

non-clinical functioning of an employee, such as performance appraisals,

personnel decisions, etc. The administrative supervisor may be held

accountable for not reporting misconduct by a psychologist when they

knew or should have known of a violation of generally accepted standards

of practice or any prohibited activity.

Modes of Supervision include but are not be limited to individual, group,

telephone, electronic mail, audio-visual, process recording, direct

observation, telesupervision, telecommunication (teleconferencing, fax,

videotapes), and hospital rounds. The appropriate modality of supervision

shall be determined by the training, education, and experience of the

supervisee, and the treatment setting (i.e. urban/rural, or the availability of

resources, etc.); and at all times based on community standards and client

needs

ocess recording, direct

observation, telesupervision, telecommunication (teleconferencing, fax,

videotapes), and hospital rounds. The appropriate modality of supervision

shall be determined by the training, education, and experience of the

supervisee, and the treatment setting (i.e. urban/rural, or the availability of

resources, etc.); and at all times based on community standards and client

needs. The level of supervision provided, including whether every case is

directly supervised and whether the supervisor meets with the client, is

determined by the education, training, and experience of the supervisee,

the specific needs of the clients being served, and the professional

judgment of the supervisor. Nothing in this Rule should be assumed to

abridge the rights of the client to a reasonable standard of care.

Supervision Shall Include But is Not Limited To The Following:

Monitoring the supervisee's activities to verify they are providing services

that meet generally accepted standards of practice.

Verifying that it is the practice of any supervisee to provide the mandatory

disclosure form as required pursuant to section 12-245-216, C.R.S.

If appropriate, verifying that clients are informed as to any changes in the

supervisory relationship.

Giving an adequate termination of supervision notice to the supervisee.

Keeping records that document supervision that meet the generally

accepted standards of practice.

Assisting the supervisee in becoming aware of and adhering to all legal,

ethical, and professional responsibilities.

Assuring that no inappropriate relationships exist between the supervisor

and supervisee, and supervisor and client.

Assuring the supervisee meets any licensing, certification or registration

requirements prior to engaging in any psychotherapy.

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d adhering to all legal,

ethical, and professional responsibilities.

Assuring that no inappropriate relationships exist between the supervisor

and supervisee, and supervisor and client.

Assuring the supervisee meets any licensing, certification or registration

requirements prior to engaging in any psychotherapy.

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Assisting to assure that the supervisee is in compliance with the Mental

Health Practice Act.

10.

Verifying and assuring the supervisee is in compliance with any existing

restricted licensure, certification or registration status or probation.

Supervisor Qualifications.

The supervisor shall have sufficient knowledge of legal, ethical, and

professional standards relevant to the clients being served.

The supervisor shall have clinical experience and competence adequate

to perform and direct the services provided by the supervisee.

1.8

REPORTING CHANGE OF ADDRESS, TELEPHONE NUMBER, OR NAME

(C.R.S. §§ 12-20-204(1), 12-245-204, 12-245-206)

Change of address, telephone number, or name.

Licensees shall inform the Division of any name, telephone number or address

change within thirty days of such change. Staff shall not change Licensees’

information without written notification from the Licensee. Notification via mail,

fax, email and the online system is acceptable. Verbal notification is not

acceptable.

Any of the following documentation is required to change a Licensee’s name or

correct a social security number or individual taxpayer identification number:

marriage license, divorce decree, court order, or documentation from the Internal

Revenue Service verifying the licensee’s valid individual taxpayer identification

number. A driver’s license or social security card with a second form of

identification may be acceptable at the discretion of the Director of Support

Services.

1.9

DUPLICATE OR REPLACEMENT LICENSE (C.R.S. §§ 12-245-206, 12-245-

209)

marriage license, divorce decree, court order, or documentation from the Internal

Revenue Service verifying the licensee’s valid individual taxpayer identification

number. A driver’s license or social security card with a second form of

identification may be acceptable at the discretion of the Director of Support

Services.

1.9

DUPLICATE OR REPLACEMENT LICENSE (C.R.S. §§ 12-245-206, 12-245-

209)

Upon licensure and at renewal, the Division will issue only one license to a

Licensee. The Division may issue a duplicate license if the Licensee submits a

written request along with the required fee.

Justification for issuance of a duplicate license may be include if the original was

lost, stolen, damaged, never received, or printed with the incorrect information, or

if the address or name has changed.

A duplicate license may also be issued for those licensees who require multiple

licenses.

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1.10 RENEWAL OF LICENSE (C.R.S. § 12-245-205(3))

Failure to Receive Renewal Notice. Failure to receive notice for renewal of

license or registration from the Board does not excuse a Licensee from the

requirement for renewal under the Act and this Rule.

Grace period. Licensees shall have a sixty-day grace period after the expiration

of their license to renew such license or registration without the imposition of a

disciplinary sanction for practicing on an expired license. During this grace period

a delinquency fee will be charged for late renewals. A Licensee who does not

renew their license within the sixty-day grace period shall be treated as having an

expired license and shall be ineligible to practice until such license is reinstated.

Military Active Duty

or registration without the imposition of a

disciplinary sanction for practicing on an expired license. During this grace period

a delinquency fee will be charged for late renewals. A Licensee who does not

renew their license within the sixty-day grace period shall be treated as having an

expired license and shall be ineligible to practice until such license is reinstated.

Military Active Duty. Licensees may be exempt from licensing requirements as

provided in section 12-20-302, C.R.S., including but not limited to, military

personnel who have been called to federally funded active duty for more than

120 days for the purpose of serving in a war, emergency, or contingency from the

payment of any professional or occupational license, certification or registration

fees, including renewal fees, and from continuing education for a renewal cycle

that falls within the period of service within the six months following the

completion of service in the war, emergency or contingency.

1.11 AUTHORITY TO INVESTIGATE (C.R.S. §§ 12-20-204(1), 12-245-204)

An application for initial license or registration, for renewal of a license or registration, or

for reinstatement of a license or registration is an express grant to the Board of full

authority to make any investigation or personal contact necessary to verify the

authenticity of the matters and information stated in the application. If the Board so

requests, the applicant must supply verification, documentation and/or complete

information on any disciplinary action taken against the applicant in any jurisdiction.

1.12 OCCUPATIONAL CREDENTIAL PORTABILITY PROGRAM (C.R.S. §§ 12-245-

207 and 12-20-202(3))

General. To be considered for licensure by endorsement under section 12-245-

207, C.R.S., an applicant must submit a completed application form, all

supporting documentation, and the appropriate fee.

Complaints/inquiries, investigations, disciplinary actions

en against the applicant in any jurisdiction.

1.12 OCCUPATIONAL CREDENTIAL PORTABILITY PROGRAM (C.R.S. §§ 12-245-

207 and 12-20-202(3))

General. To be considered for licensure by endorsement under section 12-245-

207, C.R.S., an applicant must submit a completed application form, all

supporting documentation, and the appropriate fee.

Complaints/inquiries, investigations, disciplinary actions. The Board may decline

to issue a license to an applicant for licensure by endorsement pursuant to the

Occupational Credential Portability Program the Board demonstrates by a

preponderance of evidence, after notice and opportunity for a hearing, that the

applicant:

Lacks the requisite substantially equivalent experience or credentials to

practice psychology; or

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Has committed an act that would be grounds for disciplinary action under

the law governing the practice of psychology.

Criteria. In accordance with section 12-20-202(3), C.R.S., an applicant who

possesses a current and unrestricted license, in good standing, to practice

psychology in another state or United States territory or through the federal

government, or holds a military occupational specialty, as defined in section 24-

4-201, C.R.S., may apply to the Board for licensure by endorsement pursuant to

the Occupational Credential Portability Program. To apply for endorsement, the

applicant must satisfy the following criteria:

Applicant submits to the Board:

Satisfactory proof that:

(1)

Applicant holds a doctoral degree in psychology or a

doctoral degree with a major that was determined by the

licensing, certifying, listing or registering jurisdiction to be

equivalent to a major in psychology.

(2)

Applicant attests that one (or more) of the jurisdictions by

which they have been licensed, registered, listed, or

certified:

icant submits to the Board:

Satisfactory proof that:

(1)

Applicant holds a doctoral degree in psychology or a

doctoral degree with a major that was determined by the

licensing, certifying, listing or registering jurisdiction to be

equivalent to a major in psychology.

(2)

Applicant attests that one (or more) of the jurisdictions by

which they have been licensed, registered, listed, or

certified:

(i)

Required a written examination, the content of which

tested competence to practice psychology (including

the three areas outlined in section 12-245-304(2)(b),

C.R.S.). The applicant may rely on an examination

given and passed in a jurisdiction other than the

jurisdiction from which they seek licensure by

endorsement; or

(ii)

If a written examination was not required by the

jurisdiction at the time the applicant was originally

licensed, the Board will accept as substantially

equivalent to this qualification attestation that the

applicant has a record of practicing psychology at the

independent level for at least twenty years, in any

Association of State and Provincial Psychology

Boards (ASPPB) jurisdiction under the authority of a

license which is based on a receipt of a doctoral

degree in psychology.

(3)

Applicant attests that they had one year of post-doctoral

experience practicing psychology under supervision prior to

licensure, certification, listing or registration in the jurisdiction

through which the applicant seeks licensure in Colorado; or

the applicant attests to the Board their active practice of

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psychology for one year, as defined below: “Active practice

of psychology” means the applicant has engaged in the

practice of psychology for at least twenty hours per week

averaged over the entire time they have been engaged in

practice.

e in Colorado; or

the applicant attests to the Board their active practice of

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psychology for one year, as defined below: “Active practice

of psychology” means the applicant has engaged in the

practice of psychology for at least twenty hours per week

averaged over the entire time they have been engaged in

practice.

(4)

Applicant attests that post-degree experience hours obtained

for licensure in another jurisdiction has substantially similar

requirements to what is outlined in Board Rule 1.14

Licensure by Examination. The Board may consider a

combination of post-degree hours and practice experience

on a case-by-case basis; or

Satisfactory proof that the applicant has held for at least one year a

current and unrestricted license, in good standing, to practice

psychology in another jurisdiction with a scope of practice that is

substantially similar to the scope of practice for psychologists as

specified in Part 3 of Article 245 of Title 12, C.R.S., and these rules.

Applicant must attest that they:

Have reported to the Board any injunction entered against them

and any injunctive action pending against them on any license.

Have reported any malpractice judgment, settlement, or claim, and

any pending action or claim.

Have reported any pending complaint, investigation, or disciplinary

proceeding before the licensing, grievance, or disciplinary Board of

any jurisdiction in which a license, registration or certification to

practice psychology is held and where the complaint, investigation,

or proceeding concerns the practice of psychology.

Have reported any applicable misdemeanor or felony conviction(s).

Have reported to the Board any prior disciplinary action by another

jurisdiction.

Applicant submits verification of licensure from each jurisdiction(s) in

which, and each federal agency and military service branch through

which, applicant has ever been licensed, registered, listed or certified

ns the practice of psychology.

Have reported any applicable misdemeanor or felony conviction(s).

Have reported to the Board any prior disciplinary action by another

jurisdiction.

Applicant submits verification of licensure from each jurisdiction(s) in

which, and each federal agency and military service branch through

which, applicant has ever been licensed, registered, listed or certified. The

verification can be retrieved by the applicant from the jurisdiction’s website

as long as the following information is included and can be verified if

necessary:

Date license was originally issued.

Date of license expiration.

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Disciplinary history, if applicable.

If the complete information is not available then the Verification of License

Form must be completed by each state, federal agency, or military service

branch.

Applicant submits proof that they are at least twenty-one years of age.

Exemptions

An applicant who is currently credentialed as a health service

provider in psychology in good standing by the National Register of

Health Service Providers in Psychology, or is currently a Diplomate

(Board Certified) in good standing of the American Board of

Professional Psychology (ABPP), and has a record of practicing

psychology at the independent level for at least five years in any

Association of State and Provincial Psychology Boards (ASPPB)

jurisdiction under the authority of a license which is based on

receipt of a doctoral degree in psychology shall be deemed to meet

the criteria set forth in the foregoing paragraphs (4) and (5) of this

subsection (C).

An applicant who has a current Certificate of Professional

Qualifications (CPQ) issued by the Association of State and

Provincial Psychology Boards (ASPPB) in good standing, shall be

deemed to meet the criteria set forth in the foregoing paragraphs

pt of a doctoral degree in psychology shall be deemed to meet

the criteria set forth in the foregoing paragraphs (4) and (5) of this

subsection (C).

An applicant who has a current Certificate of Professional

Qualifications (CPQ) issued by the Association of State and

Provincial Psychology Boards (ASPPB) in good standing, shall be

deemed to meet the criteria set forth in the foregoing paragraphs

(1) through (5) of this subsection (C).

Jurisprudence Examination. Applicants for both licensure and candidate

registration shall be required to pass a Board developed jurisprudence

examination.

1.13 REINSTATEMENT OF A LICENSE (C.R.S. § 12-245-205)

General. A license or registration that has expired is subject to the following

reinstatement provisions.

Application Requirements. To be considered for licensure or registration

reinstatement, an applicant must submit a completed reinstatement application

form, and the reinstatement fee.

Required statements. Each applicant for reinstatement shall certify the following:

Every license, certificate, listing or registration to practice psychology held

by applicant is in good standing;

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Applicant has reported to the Board any injunction or disciplinary action

completed or pending against their license, certificate, registration, or

listing to practice psychology or psychotherapy;

Applicant has reported to the Board any malpractice judgment against

them, any settlement of a malpractice action or claim against them, and

any malpractice action or claim pending against them in which the

malpractice alleged relates to their practice of psychology or

psychotherapy;

pending against their license, certificate, registration, or

listing to practice psychology or psychotherapy;

Applicant has reported to the Board any malpractice judgment against

them, any settlement of a malpractice action or claim against them, and

any malpractice action or claim pending against them in which the

malpractice alleged relates to their practice of psychology or

psychotherapy;

Applicant has reported to the Board any inquiry/complaint pending,

investigation being conducted by, or disciplinary proceeding pending

before the licensing, grievance, or disciplinary board of any jurisdiction in

which they are licensed, certified, registered, or listed to practice

psychology or psychotherapy in which the complaint, investigation, or

proceeding concerns their practice of psychology or psychotherapy.

Pending discipline or complaints. The Board may decline to issue a license to an

applicant for reinstatement if disciplinary action is pending or if there is an

unresolved complaint.

Continuing Professional Competence. Pursuant to section 12-245-307, C.R.S.,

effective September 1, 2017, a licensed psychologist shall complete continuing

professional development in order to reinstate a license.

An applicant for reinstatement must comply with all continuing

professional development requirements pursuant to Rule 1.20 within the

two years immediately preceding the application receipt date.

An applicant for reinstatement applying between September 1, 2017, and

August 31, 2019, must complete 1.67 continuing professional

development hours per month for the period the license was expired.

Criteria. The Board has established the following criteria for determining whether

an applicant for reinstatement has demonstrated their continued professional

competence as required by section 12-245-205(3), C.R.S. An applicant must

meet all applicable criteria to establish their continued professional competence.

License expired more than two years

h for the period the license was expired.

Criteria. The Board has established the following criteria for determining whether

an applicant for reinstatement has demonstrated their continued professional

competence as required by section 12-245-205(3), C.R.S. An applicant must

meet all applicable criteria to establish their continued professional competence.

License expired more than two years. An applicant whose license has

been expired more than two years shall pass a Board developed

jurisprudence examination and demonstrate their continued professional

competence by either:

Completion of an average of twenty Professional Development

Hours (PDH) pursuant to section 12-245-307(2)(b), C.R.S., and

Rule 1.20 for each year the license has been expired (1.67 for each

month); or

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Retaking and passing the Examination for Professional Practice in

Psychology (EPPP) national examination; or.

If an applicant for reinstatement has been licensed and performing

work in another jurisdiction that does not require continuing

professional development then verification of licensure from each

jurisdiction is required as well as a written statement detailing work

experience related to the practice of psychology during the time the

Colorado license has been expired.

Any other means approved by the Board.

1.14 LICENSURE BY EXAMINATION (C.R.S. § 12-245-304)

Criteria for application.

The applicant must submit to the Board a completed application for

licensure, all fees, official transcript(s), and all supporting documentation

required by the Board in order for the Board to review the application for

licensure.

Applications for licensure remain active for one (1) year. If the applicant

fails to become licensed within this time period, they must submit a new

application and fee and must meet the educational, experience, and

examination requirements in effect at the time of the date of the new

application

documentation

required by the Board in order for the Board to review the application for

licensure.

Applications for licensure remain active for one (1) year. If the applicant

fails to become licensed within this time period, they must submit a new

application and fee and must meet the educational, experience, and

examination requirements in effect at the time of the date of the new

application. The Board, in its sole discretion, may extend an application

upon written request accompanied by a showing of good cause.

An applicant for licensure must pass the required examination no more

than five (5) years prior to the date of the application for licensure.

Experience and supervision requirements that predate the application by

more than five (5) years will not be accepted by the Board absent a

showing of good cause, as determined by the Board. However, this may

not apply in those exceptions allowable under statutes concerning

psychologist candidates.

All applicants for licensure have a continuing obligation to update their

application with information changes from the original application at any

time prior to licensure.

All applicants for licensure shall submit, at the time of application, the

results of a name-based criminal history check from the Colorado Bureau

of Investigations with the application.

The name-based criminal history check shall comply with section

22-2-119.3 (6)(d), C.R.S.

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tion at any

time prior to licensure.

All applicants for licensure shall submit, at the time of application, the

results of a name-based criminal history check from the Colorado Bureau

of Investigations with the application.

The name-based criminal history check shall comply with section

22-2-119.3 (6)(d), C.R.S.

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The name-based criminal history check shall be completed no

earlier than 60 days prior to the date of application.

Education and Training Requirements. Many graduate programs in psychology

go under other names. Some programs labeled as psychology are not primarily

focused on psychology. The Board has therefore established the following

factors to determine whether a particular program from which an applicant for

licensure received the doctoral degree qualifies as a doctoral program with a

major in psychology or its equivalent in compliance with sections 12-245-

304(1)(c) and 12-245-301(1) and (5), C.R.S. To meet the statutory requirements,

the doctoral program must meet either (1) or (2), below:

Accredited program. The applicant obtained a doctoral degree from a

program that was accredited by the American Psychological Association

(APA); or

Equivalent program. The applicant received a doctoral degree from a

graduate training program that, at the time they were enrolled and

received their degree, fulfilled the equivalency degree requirements used

to define a psychology graduate training program. An applicant asserting a

program equivalent to an APA-accredited program in psychology must

furnish to the Board evidence in support of the equivalency. Evidence may

include narrative descriptions of course-work, institutional documents

published contemporaneously with the applicant's enrollment, appropriate

certifications or affidavits from university officials, dissertation abstracts,

and any other evidence the applicant deems useful. The Board may

request additional information from the applicant

he Board evidence in support of the equivalency. Evidence may

include narrative descriptions of course-work, institutional documents

published contemporaneously with the applicant's enrollment, appropriate

certifications or affidavits from university officials, dissertation abstracts,

and any other evidence the applicant deems useful. The Board may

request additional information from the applicant.

All of the following requirements shall be considered in order to establish

equivalency:

The required doctoral level study and doctoral degree were

obtained from a regionally accredited institution of higher learning;

The program in psychology stood as a coherent and recognizable

entity within the institution, offering an integrated and organized

sequence of study planned to provide appropriate training for the

practice of psychology;

There was an identifiable full-time faculty, with an individual

responsible for the program who was a full-time faculty member

and who met the requirements for approval as a supervisor or a

person who presents proof satisfactory to the Board, that at the

time of serving as the faculty member, they possessed essentially

the same education, experience, and training as that necessary to

qualify for licensure under the Act.

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The program had an identifiable body of students who were

matriculated in that program for a degree;

The doctoral program included examination and grading

procedures designed to evaluate the degree of mastery of the

subject matter by the students;

The curriculum encompassed a minimum of three academic years

of full-time graduate study including the following substantive

content areas:

(1)

Professional ethics and standards;

(2)

Research design and methodology: techniques of data

analysis, inferential statistics, descriptive statistics, research

implementation, program evaluation and assessment;

stery of the

subject matter by the students;

The curriculum encompassed a minimum of three academic years

of full-time graduate study including the following substantive

content areas:

(1)

Professional ethics and standards;

(2)

Research design and methodology: techniques of data

analysis, inferential statistics, descriptive statistics, research

implementation, program evaluation and assessment;

(3)

Theories and methods of effective intervention: consultation,

supervision, evaluation of treatment efficacy;

(4)

Theories and methods of assessment and diagnosis;

(5)

Biological bases of behavior: physiological psychology,

neuropsychology, sensation and perception, comparative

psychology, psychopharmacology;

(6)

Cognitive-affective bases of behavior: learning, thinking,

motivation, and emotion;

(7)

Social bases of behavior: social psychology, group

processes, organizational and systems theory;

(8)

Individual differences: personality theory, human

development, abnormal psychology;

(9)

Issues of cultural and individual diversity.

(10)

If the course titles as stated on the transcript do not clearly

reflect the subject matters listed above, the applicant must

document the course or combination of courses in which the

material was covered.

The program included supervised practicum and internship

appropriate to the practice of psychology.

(1)

Practicum. The minimum practicum experience is 400 hours,

of which at least 150 hours must have been in direct service

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experience and at least seventy-five hours in formally

scheduled supervision.

as covered.

The program included supervised practicum and internship

appropriate to the practice of psychology.

(1)

Practicum. The minimum practicum experience is 400 hours,

of which at least 150 hours must have been in direct service

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experience and at least seventy-five hours in formally

scheduled supervision.

(2)

Internship. To be acceptable, internships in clinical

psychology must include at least a full-time experience,

either for one full-time calendar year or for two half-time

calendar years and must encompass at least 1,500

experience hours. To be acceptable, school and counseling

psychology internships must include at least a full-time

experience, for either an academic or calendar year or for

two half-time academic or calendar years and must

encompass at least 1,500 experience hours. To be

acceptable, internships must be accredited by the American

Psychological Association (APA) or be substantially

equivalent when compared with the guidelines and principles

for accreditation of internships published by the APA.

Only graduate level courses are acceptable as establishing

equivalency. The Board will not accept coursework counted or

credited toward an undergraduate degree.

Foreign-Trained Applicants. Foreign-trained applicants must submit

educational credentials to a credentialing agency utilized by the Board for

evaluation of equivalency. After course equivalency is established, the

Board will evaluate the educational credentials to determine whether or

not the program is equivalent to an APA-approved program.

Post-Graduate Experience Requirements. The Board will approve a post-doctoral

supervised practice as meeting the requirements for licensure set out in section

12-245-304(1)(d), C.R.S., when that practice satisfies the requirements of this

subsection.

Definitions. As used in section 12-245-304(1)(d), C.R.S., and in this Rule,

unless the context indicates otherwise:

an APA-approved program.

Post-Graduate Experience Requirements. The Board will approve a post-doctoral

supervised practice as meeting the requirements for licensure set out in section

12-245-304(1)(d), C.R.S., when that practice satisfies the requirements of this

subsection.

Definitions. As used in section 12-245-304(1)(d), C.R.S., and in this Rule,

unless the context indicates otherwise:

“Individual supervision” means supervision rendered to one

individual at a time.

“Group supervision” means supervision rendered to not more than

ten individuals at one time.

“Post-doctoral experience” means experience under approved

supervision acquired subsequent to the date certified by the

degree-granting institution as that on which all requirements for the

doctoral degree have been completed.

“Practice in “psychology” means all services included within the

definition of psychotherapy in section 12-245-202(14), C.R.S., and

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particularly those services and practices included within the

definition of psychological services in section 12-245-303, C.R.S.

“Supervision” means personal direction and responsible direction

provided by a supervisor approved by the Board.

(1)

“Personal direction” means direction actually rendered by the

approved supervisor.

(2)

“Responsible direction” or “direction” means the approved

supervisor has sufficient knowledge of all clients for whom

supervision is provided, including face-to-face contact with

the client when necessary, to develop and to monitor

effective service delivery procedures and the supervisee’s

treatment plan. Further, all decision requiring the special

skill, knowledge, and/or training of a psychologist are made

in collaboration with, and with the approval of, the approved

supervisor

knowledge of all clients for whom

supervision is provided, including face-to-face contact with

the client when necessary, to develop and to monitor

effective service delivery procedures and the supervisee’s

treatment plan. Further, all decision requiring the special

skill, knowledge, and/or training of a psychologist are made

in collaboration with, and with the approval of, the approved

supervisor. Such decisions include, but are not limited to:

type, duration, effectiveness, and method of psychotherapy

services provided; fees and billing procedures; approval of

cases; and personal observation, evaluation, oversight,

review, and correction of services provided by the

supervisee.

“Consultation” describes a voluntary relationship between

professionals of relative equal expertise or status wherein the

consultant offers their best advice or information on an individual

case or problem for use by the consultee as they deem appropriate

in their professional judgment. Consultation is not supervision.

Experience under contract for consultation will not be credited

toward fulfillment of supervision requirements.

Certification of Completion. Each applicant shall file with the Board, upon

forms supplied by the Board, a verified statement signed under penalty of

law by their approved supervisor(s) attesting to the applicant’s satisfactory

completion of the required post-doctoral practice of psychotherapy under

supervision and attesting to the applicant’s having met the generally

accepted standards of practice during the supervised practice.

Supervision.

The Board will accept any of the following as a supervisor:

(1)

A licensed psychologist who, at the time of supervision, was

licensed by the Board in the jurisdiction in which the

applicant’s services were performed.

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et the generally

accepted standards of practice during the supervised practice.

Supervision.

The Board will accept any of the following as a supervisor:

(1)

A licensed psychologist who, at the time of supervision, was

licensed by the Board in the jurisdiction in which the

applicant’s services were performed.

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(2)

A psychiatrist certified by the American Board of Psychiatry

and Neurology and who was licensed as a physician who, at

the time of supervision, was licensed by the Board in the

jurisdiction in which the applicant’s services were performed,

who had completed a psychiatric residency at the time of the

supervision, and who certified to the Board their competence

in the same area as that in which the applicant received

post-doctoral experience practicing psychology under

supervision. For such supervision to count towards

licensure, it must have been conducted in accordance with

these Rules and the Act as determined by the Board. A

psychologist must supervise the psychological testing.

(3)

A psychologist may be approved as a supervisor, who, at the

time of the supervision, was licensed at the highest possible

level in another jurisdiction in which the applicant's services

were performed. The Board will consider post-degree

supervised experience obtained in another jurisdiction by an

individual who is not certified or licensed as a psychologist in

the other jurisdiction, if the jurisdiction in which such person

was practicing did not provide for such certification,

licensure, listing or registration. The applicant’s supervisor

shall document to the satisfaction of the Board their

competence in the same field of psychology as that in which

the applicant is seeking licensure.

individual who is not certified or licensed as a psychologist in

the other jurisdiction, if the jurisdiction in which such person

was practicing did not provide for such certification,

licensure, listing or registration. The applicant’s supervisor

shall document to the satisfaction of the Board their

competence in the same field of psychology as that in which

the applicant is seeking licensure.

The approved supervisor shall keep records that will enable them to

effectively train, evaluate, and credit the applicant for licensure with

the exact number of hours of acceptable post-doctoral practice of

psychotherapy and the exact number of hours of supervision

completed in compliance with this Rule.

Number of hours of post-doctoral experience practicing psychology under

supervision.

The post-doctoral experience practicing psychology under

supervision cannot be completed in fewer than twelve months and

may involve supervision by more than one approved supervisor as

defined in these Rules.

The one year of post-doctoral experience practicing psychology

under supervision required by section 12-245-304(1)(d), C.R.S.,

must have at least 1,500 clock hours obtained in such a manner

that they are reasonably uniformly distributed over a minimum of

twelve months.

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The teaching of psychology may count for up to 500 hours of post-

doctoral experience practicing psychology under supervision and

up to twenty-five hours of supervision provided such teaching was

in courses in the same or similar field of psychology as the

competence area claimed by the applicant and that this experience

was supervised by a supervisor defined in these Rules.

The post-doctoral experience obtained under the supervision of a

board-certified psychiatrist may count for up to 375 hours of

experience and up to 17.75 hours of supervision.

upervision provided such teaching was

in courses in the same or similar field of psychology as the

competence area claimed by the applicant and that this experience

was supervised by a supervisor defined in these Rules.

The post-doctoral experience obtained under the supervision of a

board-certified psychiatrist may count for up to 375 hours of

experience and up to 17.75 hours of supervision.

Research experience hours may count for up to 500 hours of post-

doctoral experience practicing psychology under supervision and

up to twenty-five hours of supervision provided such research

experience was performed in the same or similar field of

psychology as the competence area claimed by the applicant and

provided that this experience was supervised by an approved

supervisor.

Training in the subject area of racial/ethnic bases of behavior must

count at least fifty hours of the post-doctoral experience practicing

psychology under supervision and three hours of supervision must

be focused in this area. Coursework may be substituted, as long as

the courses(s) submitted, is clearly documented and is equivalent

to three semester or five quarter hours of graduate level credit.

Number of hours of post-doctoral supervision.

Applicants must receive a minimum of seventy-five clock hours of

supervision, at least fifty of which must be face-to-face individual

supervision. The remaining hours up to the seventy-five hours may

only be by group supervision. No other modes of supervision will be

accepted.

The post-doctoral supervision hours must be reasonably distributed

over a minimum of twelve months in a manner consistent with the

accrual of supervised post-doctoral experience.

Examination. In accordance with sections 12-245-204(4)(b) and 12-245-304, et

seq., C.R.S., the Board establishes these requirements for the licensing

examination to demonstrate professional competence in psychology.

Jurisprudence Examination

ion hours must be reasonably distributed

over a minimum of twelve months in a manner consistent with the

accrual of supervised post-doctoral experience.

Examination. In accordance with sections 12-245-204(4)(b) and 12-245-304, et

seq., C.R.S., the Board establishes these requirements for the licensing

examination to demonstrate professional competence in psychology.

Jurisprudence Examination. Applicants for both licensure and candidate

registration shall be required to pass a Board-developed jurisprudence

examination.

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National Examination. The examination covering the general areas of

knowledge in psychology shall be administered under contract with the

Examination for Professional Practice in Psychology (EPPP).

Application. An applicant for licensure shall apply directly to the

Association of State and Provincial Psychology Boards (ASPPB), or any

other testing service the Board may contract with at the time, to sit for the

appropriate examination.

Exam Results. Examination results will be valid for up to five years after

the date of the examination.

1.15 MILITARY EDUCATION, TRAINING AND EXPERIENCE (C.R.S. § 12-20-

202(4))

Education, training, or service gained in military services outlined in section 12-20-

202(4), C.R.S., to be accepted and applied towards receiving a license, must be

substantially equivalent, as determined by the Board, to the qualifications otherwise

applicable at the time of receipt of application. It is the applicant’s responsibility to

provide timely and complete evidence for review and consideration. Satisfactory

evidence of such education, training, or service will be assessed on a case by case

basis.

1.16 RECORDS REQUIRED TO BE KEPT AND RECORD RETENTION (C.R.S. §§

12-245-204(4), 12-245-224(1)(u))

General. Every psychologist engaged in the practice of psychology as defined in

section 12-245- 303, C.R.S., shall create and maintain records on each of their

psychology clients

d consideration. Satisfactory

evidence of such education, training, or service will be assessed on a case by case

basis.

1.16 RECORDS REQUIRED TO BE KEPT AND RECORD RETENTION (C.R.S. §§

12-245-204(4), 12-245-224(1)(u))

General. Every psychologist engaged in the practice of psychology as defined in

section 12-245- 303, C.R.S., shall create and maintain records on each of their

psychology clients. The psychologist shall retain a record on each psychology

client for a period of seven years commencing on the date of termination of

psychology services or on the date of last date of treatment with the client,

whichever is later. Exception. When the client is a child, the record shall be

retained for a period of seven years commencing either upon the last date of

treatment or when the child reaches eighteen years of age, whichever is later.

Record. A record shall contain, as applicable to the mental health services

rendered, at least the following information:

Name of the treating therapist;

Client’s identifying data to include name, address, telephone number,

gender, date of birth, and if applicable the name of the parent or guardian.

If the client is an organization, the name of the organization, telephone

number and name of the principal authorizing the mental health provider’s

services or treatment;

Reason for the psychology/psychotherapy services;

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telephone number,

gender, date of birth, and if applicable the name of the parent or guardian.

If the client is an organization, the name of the organization, telephone

number and name of the principal authorizing the mental health provider’s

services or treatment;

Reason for the psychology/psychotherapy services;

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Mandatory disclosure statement(s);

Dates of service including, but not limited to the date of each contact with

client, the date on which services began, and the date of last contact with

client;

Types of service;

Fees;

Any release of information;

If any of the following have been written: assessment, plan for

intervention, consultation, summary reports, and/or testing reports and

supporting data. The records must be prepared in a manner that allows

any subsequent provider to yield a comprehensive conclusion as to what

occurred;

10.

Name of any test administered, each date on which the test was

administered, and the name(s) of the person(s) administering the test;

11.

Information on each referral made to and each consultation with another

therapist or other health care provider. This information shall include the

date of referral or consultation, the name of the person to whom the client

was referred, the name of the person with whom consultation was sought;

the outcome (if known) of the referral, and the outcome (if known) of the

consultation;

12.

Records of counseling, interview notes, correspondence, audio or visual

recordings, electronic data storage, and other documents considered

professional information for use in counseling; and

13.

A final closing statement (if services are over).

Record Storage. Every psychologist shall keep and store client records in a

secure place and in a manner that both assures that only authorized persons

have access to the records and protects the confidentiality of the records.

Transfer of Records

storage, and other documents considered

professional information for use in counseling; and

13.

A final closing statement (if services are over).

Record Storage. Every psychologist shall keep and store client records in a

secure place and in a manner that both assures that only authorized persons

have access to the records and protects the confidentiality of the records.

Transfer of Records. Whenever a psychologist deems it necessary to transfer

their records to another psychologist or other health care provider, the

psychologist making the transfer shall obtain the client’s consent to transfer

(when possible).

Disposition of records. If the psychologist is not available to handle their own

records, the psychologist and/or his estate shall designate an appropriate person

to handle the disposition of records. A plan for the disposition of records shall be

in place for all psychologists for the following conditions:

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Disability, illness or death of the psychologist;

Termination of the psychologist’s practice.

Record Destruction. Every psychologist shall dispose of client records in a

manner or by a process that destroys or obliterates all client identifying data.

However, records cannot be destroyed until after seven years or as otherwise

provided in these Rules or all other applicable statutes.

Record keeping in agency/institutional settings. A psychologist need not create

and maintain separate client records if the psychologist practices in an agency or

institutional setting and the psychologist:

Sees the client in the usual course of that practice;

Keeps client records as required by the agency or institution; and

The agency or institution maintains client records.

1.17 RELIGIOUS MINISTRY EXEMPTIONS (C.R.S. § 12-245-217(1))

psychologist need not create

and maintain separate client records if the psychologist practices in an agency or

institutional setting and the psychologist:

Sees the client in the usual course of that practice;

Keeps client records as required by the agency or institution; and

The agency or institution maintains client records.

1.17 RELIGIOUS MINISTRY EXEMPTIONS (C.R.S. § 12-245-217(1))

Whenever an exemption from the Board’s jurisdiction is claimed based on an

assertion of the practice of religious ministry as stated in section 12-245-217(1),

C.R.S., the Board shall consider factors, including but not limited to those listed

below, which, taken together and placed within the context of the incident in

question, would tend to reasonably indicate that the person seeking the

exemption was engaged in the practice of religious ministry. Before taking action

on a complaint, the Board shall consider the following factors and other

information that indicates the person claiming exemption was not engaged in the

practice of religious ministry at the time of the alleged violation of the statute. If

the Board determines that this exemption applies, and the Licensee was

practicing religious ministry, the Board will have no jurisdiction to take any further

action on the complaint.

In determining whether the practice of psychotherapy has occurred, the Board

analyzes activities and the basic nature of the interaction among the persons

involved. The analysis focuses on what occurred, on how it occurred, and on why

it occurred.

Factors.

Whether the client or guardian had received notice or reasonably

understood that the therapy in question was a part of religious

practice/ministry.

Whether the client or guardian was seeking therapy from a religious

organization to which the complainant belonged at any time.

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, and on why

it occurred.

Factors.

Whether the client or guardian had received notice or reasonably

understood that the therapy in question was a part of religious

practice/ministry.

Whether the client or guardian was seeking therapy from a religious

organization to which the complainant belonged at any time.

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Whether a written agreement or disclosure existed that stated that the

therapy in question was part of religious practice/belief.

Whether the therapy services were conducted in a house of worship or on

property belonging to a religious organization.

Whether the provider of the therapy services normally represents him or

herself as a religious official who is counseling as part of a religious

ministry.

Whether the therapy services were part of an on-going relationship,

formed because the provider is spiritual counselor to the client.

Whether the provider of therapy services holds a position of trust within a

religious organization.

Whether the provider of the therapy services advertise psychotherapy

services to the general public for a fee.

Whether the provider of the therapy services collects fees or

expects/requires donations, offerings, tithes, etc.

10.

Whether the therapy services provided are based on any religious

orientation or viewpoint.

11.

Whether the provider engaged in the practice of therapy services is

accountable or subject to any religious organization or person for

misdeeds or acts of misconduct.

12.

Whether the provider of therapy services is a member of a religious

organization recognized by the Internal Revenue Service. Whether the

organization holds 501(C)(3) tax exempt status.

13.

Whether the provider of therapy services is trained in theology or any

other field, area, or specialty related to the study of a religious or spiritual

orientation.

14.

Whether the service provided within a private practice setting.

therapy services is a member of a religious

organization recognized by the Internal Revenue Service. Whether the

organization holds 501(C)(3) tax exempt status.

13.

Whether the provider of therapy services is trained in theology or any

other field, area, or specialty related to the study of a religious or spiritual

orientation.

14.

Whether the service provided within a private practice setting.

15.

Whether the provider of the therapy services has a declaration of religious

mission or a statement identifying the religious views or beliefs of the

organization or person.

1.18 IMPOSITION OF ADMINISTRATIVE FINES (C.R.S. § 12-245-225(2))

Fines; Non-Exclusive Sanction. The Board, in its discretion, may impose a fine or

fines in lieu of, or in addition to, any other disciplinary sanction. The term

psychologist as contemplated under section 12-245-225(2), C.R.S., and this Rule

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shall include any person who has been licensed at any time under the Mental

Health Practice Act to practice psychology.

Fine for Each Violation. Section 12-245-225(2), C.R.S., provides authority for the

Board to impose an administrative fine against a psychologist for a violation of an

administrative requirement. The Board, in its discretion, may impose a separate

fine for each violation and shall consider the nature and seriousness of the

violation prior to imposing any fine.

Fines: Schedule of Fines. The Board may so impose a fine or fines consistent

with the following schedule:

For a psychologist’s first violation, a fine of no more than $1,000.00.

For a psychologist’s second violation, a fine of no more than $2,500.00.

For a psychologist’s third and any additional violations, a fine of no more

than $5,000.00.

In determining the number of violations for purposes of application of the above

schedule, the Board may count as a violation, each prior violation adjudicated

against the psychologist.

Payment of Fines.

Fine Amount; When Due

For a psychologist’s second violation, a fine of no more than $2,500.00.

For a psychologist’s third and any additional violations, a fine of no more

than $5,000.00.

In determining the number of violations for purposes of application of the above

schedule, the Board may count as a violation, each prior violation adjudicated

against the psychologist.

Payment of Fines.

Fine Amount; When Due. A total fine amount of $500.00 or less imposed

by the Board must be paid in full, including the applicable surcharge, at

the time the Final Agency Order is entered or a Stipulation is reached

between the parties. A total fine amount greater than $500.00 imposed by

the Board must be paid in full, including the applicable surcharge, in

accordance with the time frame set forth in the Final Agency Order or

Stipulation.

Delinquent Payment Consequences. A psychologist who fails to pay a fine

imposed under this Rule as defined above pursuant to a Final Agency

Order or Stipulation may be subject to further discipline, including

suspension or revocation of his or her license to practice. Section 12-245-

224(1)(b), C.R.S., provides that violation of an Order of the Board is a

Prohibited Activity.

Compliance with Law. Payment of a fine does not exempt the psychologist from

continuing compliance with the Mental Health Practice Act or any orders of the

Board.

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vocation of his or her license to practice. Section 12-245-

224(1)(b), C.R.S., provides that violation of an Order of the Board is a

Prohibited Activity.

Compliance with Law. Payment of a fine does not exempt the psychologist from

continuing compliance with the Mental Health Practice Act or any orders of the

Board.

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1.19 CONFIDENTIAL AGREEMENTS TO LIMIT PRACTICE FOR PHYSICAL OR

MENTAL ILLNESS (C.R.S. § 12-245-223)

Notice to Board. No later than thirty days from the date a physical or mental

illness or condition impacts a psychologist’s ability to perform professional

services with reasonable skill and safety, the psychologist shall provide the

Board, in writing, the following information:

The diagnosis and a description of the illness or condition;

The date that the illness or condition was first diagnosed;

The name of the current treatment provider and documentation from the

current treatment provider confirming the diagnosis, date of onset, and

treatment plan;

A description of the psychologist’s practice and any modifications,

limitations or restrictions to that practice that have been made as a result

of the illness or condition;

Whether the psychologist has been evaluated by, or is currently receiving

services from the Board’s authorized Peer Health Assistance Program

related to the illness or condition and, if so, the date of initial contact and

whether services are ongoing.

Change of Circumstances; Further Notice. The psychologist shall further notify

the Board of any significant change in the illness or condition (“change of

condition”) that impacts the psychologist’s ability to perform a professional

service with reasonable skill and safety. The psychologist must notify the Board

of a positive or negative change of condition. Such notification shall occur within

thirty days of the change of condition. The psychologist shall provide the Board,

in writing, the following information:

e illness or condition (“change of

condition”) that impacts the psychologist’s ability to perform a professional

service with reasonable skill and safety. The psychologist must notify the Board

of a positive or negative change of condition. Such notification shall occur within

thirty days of the change of condition. The psychologist shall provide the Board,

in writing, the following information:

The date of the change of condition;

The name of the current treatment provider and documentation from the

current treatment provider confirming the change of condition, the date

that the condition changed, the nature of the change of condition, and the

current treatment plan;

A description of the psychologist’s practice and any modifications,

limitations or restrictions to that practice that have been made as a result

of the change of condition;

Whether the psychologist has been evaluated by, or is currently receiving

services from, the peer health assistance program related to the change of

condition and, if so, the date of initial contact and whether services are

ongoing.

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Confidential Agreement; Board Discretion. Compliance with this Rule is a

prerequisite for eligibility to enter into a Confidential Agreement with the Board

pursuant to section 12-245-223, C.R.S. However, mere compliance with this Rule

does not require the Board to negotiate regarding, or enter into, a Confidential

Agreement. Rather, the Board will evaluate all facts and circumstances to

determine if a Confidential Agreement is appropriate.

Failure to Notify

ule is a

prerequisite for eligibility to enter into a Confidential Agreement with the Board

pursuant to section 12-245-223, C.R.S. However, mere compliance with this Rule

does not require the Board to negotiate regarding, or enter into, a Confidential

Agreement. Rather, the Board will evaluate all facts and circumstances to

determine if a Confidential Agreement is appropriate.

Failure to Notify. If the Board discovers that a psychologist has a mental or

physical illness or condition that impacts the psychologist’s ability to perform a

psychological service with reasonable skill and safety and the psychologist has

not notified the Board as required under these Rules of such illness or condition,

the psychologist shall not be eligible for a Confidential Agreement and may be

subject to disciplinary action for failure to notify under section 12-245-223(1),

C.R.S., and other related violations contemplated under section 12-245-224(1)(f),

C.R.S.

1.20 CONTINUING PROFESSIONAL DEVELOPMENT (C.R.S. § 12-245-307)

Psychology candidates shall complete continuing professional development and

educational hours prior to a second or subsequent renewal of a psychology candidate

registration to maintain the psychology candidate registration. Prescribing psychologists

must demonstrate completion of the professional development requirements detailed in

section 1.24 (G) herein. The provisions of this section 1.20 also apply to prescribing

psychologists.

Terms/Definitions.

Continuing Education Units (CEU)/ Continuing Medical Education

(CME)/Continuing Education (CE) means learning activities approved

and/or accredited by the American Psychological Association, state

medical association or Accreditation Council for Continuing Medical

Education (ACCME) or by a regionally accredited institution of higher

education.

Continuing Professional Development (CPD) is the Board’s program

through which a licensed psychologist satisfies the requirements set forth

in section 12-245-307, C.R.S

ies approved

and/or accredited by the American Psychological Association, state

medical association or Accreditation Council for Continuing Medical

Education (ACCME) or by a regionally accredited institution of higher

education.

Continuing Professional Development (CPD) is the Board’s program

through which a licensed psychologist satisfies the requirements set forth

in section 12-245-307, C.R.S. and ensures the ongoing ability of a

licensed psychologist or psychology candidate to learn, integrate, and

apply the knowledge, skill, and judgement to practice psychology

according to generally accepted industry standards and professional

ethical standards.

Continuing Professional Development Manual (CPD Manual) is an

instructional guide and workbook for the CPD program.

Learning Plan is the board approved form used to develop, execute, and

document Professional Development Hours (PDH) for each cycle in the

CPD program as set forth in section 12-245-307(2)(a), C.R.S.

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Military Exemption is a method to satisfy continuing professional

development requirements. A licensed psychologist who has been

approved for this exemption will not be required to meet continuing

professional development requirements during the renewal period in which

the military exemption was approved by the Division of Professions and

Occupations (DPO).

Professional Development Hours (PDH) are the units of measurement of

active learning used to accrue credit in the CPD program. PDH are

equivalent to clock hours.

Reflective Self-Assessment Tool (RSAT) is an optional self-reflective

practice tool that can be used to assist a licensed psychologist in

developing a learning plan.

Continuing Professional Development Requirements.

A licensed psychologist or psychology candidate shall complete continuing

professional development requirements in order to renew a license to

practice psychology in the State of Colorado by:

-Assessment Tool (RSAT) is an optional self-reflective

practice tool that can be used to assist a licensed psychologist in

developing a learning plan.

Continuing Professional Development Requirements.

A licensed psychologist or psychology candidate shall complete continuing

professional development requirements in order to renew a license to

practice psychology in the State of Colorado by:

Successfully participating in the CPD program; or

Receiving an exemption for military service as defined in section

12-20-302, C.R.S., and section (E) of this Rule.

A licensed psychologist shall attest at the time of the renewal of a license

to compliance with continuing professional development requirements.

The registered psychology candidate shall complete continuing

professional development and educational hours prior to a second or

subsequent renewal in order to renew the psychology candidate

registration in the State of Colorado.

Continuing Professional Development (CPD) Program.

In accordance with section 12-245-307(2), C.R.S., and the current CPD

manual, the CPD program consists of the following elements:

Development, execution, and documentation of a learning plan:

(1)

A licensed psychologist or psychology candidate shall

develop a learning plan consisting of PDH as set forth in

section 12-245-307(2)(b), C.R.S., and this Rule.

(2)

A licensed psychologist or psychology candidate shall

execute this learning plan by completing and documenting

all PDH before the date upon which the licensed

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psychologist renews their license. Changes to the learning

plan shall not be allowed after a license is renewed.

2-245-307(2)(b), C.R.S., and this Rule.

(2)

A licensed psychologist or psychology candidate shall

execute this learning plan by completing and documenting

all PDH before the date upon which the licensed

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psychologist renews their license. Changes to the learning

plan shall not be allowed after a license is renewed.

(3)

A licensed psychologist can choose to use the optional

Reflective Self-Assessment Tool (RSAT) when creating a

learning plan.

Completion of forty (40) hours of PDH through a combination of

allowed activities as described in section 12-245-307(2)(b), C.R.S.,

and as chosen by the licensed psychologist; and

Maintaining documentation of completed PDH as described in

sections 12-245-307(2)(b) and (c), C.R.S.

Registered psychology candidates shall complete sixty (60) PDH at the

second subsequent renewal cycles as set forth in section 12-245-

307(2)(b), C.R.S., and this Rule.

A licensed psychologist shall complete forty (40) PDH each renewal cycle

before renewing a license.

PDH must be relevant to the licensed psychologist’s learning plan

and maintain or enhance competence as a licensed psychologist.

The licensed psychologist should be able to describe how learning

activities sharpened existing and/or provided new knowledge or

skills.

PDH credit can only be earned for activities as specifically

described in section 12-245-307(2), C.R.S., and section (E) of this

Rule.

The Board will not pre-approve courses or providers and has sole

discretion to accept or reject PDH that do not meet the criteria

established in section 12-245-307(2)(b), C.R.S., and the CPD

manual.

A licensed psychologist who receives an original, reinstated, or

reactivated license during the renewal cycle must accrue 1.67 PDH

for each month or portion thereof they are licensed prior to the end

of the renewal cycle.

prove courses or providers and has sole

discretion to accept or reject PDH that do not meet the criteria

established in section 12-245-307(2)(b), C.R.S., and the CPD

manual.

A licensed psychologist who receives an original, reinstated, or

reactivated license during the renewal cycle must accrue 1.67 PDH

for each month or portion thereof they are licensed prior to the end

of the renewal cycle.

A licensed psychologist shall document completion of PDH

according to the guidelines set forth in section 12-245-307(2),

C.R.S., and the current CPD manual and must be prepared to

submit documentation of compliance upon request by the board.

A maximum of ten (10) PDH may be carried from the last renewal

cycle to the next renewal cycle if the PDH were earned within three

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(3) months of license expiration and are in excess of the forty (40)

PDH required for the current renewal cycle.

To qualify for PDH credit, a psychologist must select learning activities as

defined in section 12-245-307(2)(b), C.R.S. PDH must include one or

more of the following activities, in any combination:

Attending workshops, seminars, symposia, colloquia, invited

speaker sessions, postdoctoral institutes, or scientific or

professional programs offered at meetings of local, state, regional,

national, or international professional or scientific organizations.

(1)

With the exception of five (5) PDH, activities must qualify as

continuing education units, continuing medical education , or

continuing education as approved and/or accredited by the

American Psychological Association, State Medical

Association, Accreditation Council For Continuing Medical

Education, or by a regionally accredited institution of higher

education.

(2)

Activities may include online continuing education.

(3)

One (1) continuing education hour is equivalent to one (1)

PDH.

s, continuing medical education , or

continuing education as approved and/or accredited by the

American Psychological Association, State Medical

Association, Accreditation Council For Continuing Medical

Education, or by a regionally accredited institution of higher

education.

(2)

Activities may include online continuing education.

(3)

One (1) continuing education hour is equivalent to one (1)

PDH.

(4)

Documentation of learning activities shall include a transcript

or certificate of attendance with a statement of the credits

earned, which includes the name of the participant, the

date(s) of attendance, the name of provider(s), the number

of hours earned, etc.

Completing an ethics course offered by the American Psychological

Association, State Medical Association, Accreditation Council for

Continuing Medical Education, or a regionally accredited institution

of higher education.

(1)

One (1) continuing education hour is equivalent to one (1)

PDH.

(2)

Documentation of completion of an ethics course shall

include a transcript or certificate of attendance with a

statement of the credits earned, which includes the name of

the participant, the date(s) of attendance, the name of the

provider(s), the number of hours earned, etc.

Developing and teaching an academic course in psychology at an

institution accredited by a regional accrediting association.

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(1)

Credit can be earned for the first time within a given

licensure cycle that the licensed psychologist develops and

teaches the course.

(2)

One (1) academic credit, unit, or hour is equivalent to ten

(10) PDH.

(3)

Documentation of the development and teaching of an

academic course shall include written verification by the

dean or head of the department of the institution in which the

course was taught.

Successfully completing a graduate course in psychology offered

by an institution accredited by a regional accrediting association.

One (1) academic credit, unit, or hour is equivalent to ten

(10) PDH.

(3)

Documentation of the development and teaching of an

academic course shall include written verification by the

dean or head of the department of the institution in which the

course was taught.

Successfully completing a graduate course in psychology offered

by an institution accredited by a regional accrediting association.

(1)

One (1) academic credit, unit, or hour is equivalent to ten

(10) PDH.

(2)

Documentation shall include an academic transcript showing

the graduate credits earned.

Developing and presenting a workshop, seminar, symposium,

colloquium, or invited speaking session, at a meeting of a

professional or a scientific organization or a postdoctoral institute.

(1)

Credit can be earned for the first time within a given

licensure cycle that the workshop, seminar, symposium,

colloquium, or invited speaking session is developed and

presented.

(2)

One (1) hour of workshop, seminar, symposium, colloquial

presentation, or invited speaking session is equivalent to

three (3) PDH.

(3)

Documentation shall include a printed program or agenda

showing the name of the licensed psychologist, the date(s)

of the presentation, the name of the organization, the total

number of hours presented, etc.

Authoring or editing a psychology publication, maximum hours

earned as following:

(1)

Authoring a professional or scientific book is equivalent to

forty (40) PDH.

(2)

Authoring a professional or scientific book chapter or journal

article is equivalent to twenty (20) PDH.

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(3)

Editing a professional or scientific book or journal is

equivalent to thirty (30) PDH.

maximum hours

earned as following:

(1)

Authoring a professional or scientific book is equivalent to

forty (40) PDH.

(2)

Authoring a professional or scientific book chapter or journal

article is equivalent to twenty (20) PDH.

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(3)

Editing a professional or scientific book or journal is

equivalent to thirty (30) PDH.

(4)

Documentation shall include a coversheet, masthead, or

table of contents from the publication showing the name of

the licensed psychologist, the date of authoring or editing,

etc.

Providing editorial review of a professional psychological or

scientific journal article at the request of the journal’s editorial staff.

(1)

Completion of activity is equivalent to one (1) PDH.

(2)

Documentation shall include the acknowledgment of the

completed review by the editorial staff with the name of the

licensed psychologist, date of review, etc.

Audit of Compliance. As set forth in section 12-245-307(4), C.R.S., the Board

may audit up to five percent (5%) of licensed psychologists each two-year cycle

to determine compliance with continuing professional development requirements.

The following documentation is required for an audit of compliance:

A learning plan signed by the licensed psychologist that contains

the licensed psychologist’s completed PDH in the manner set forth

in the current CPD Manual;

Documentation of the required PDH in compliance with statute, this

Rule, and the current CPD Manual; and

The Board has sole discretion to accept or reject PDH that do not

meet the criteria established as defined in section 12-245-307(2),

C.R.S., this Rule, and the current CPD Manual.

As set forth in section 12-245-307(5)(a), C.R.S., records of assessment or

other documentation developed or submitted in connection with the

continuing professional development program are confidential and not

subject to inspection by the public or discovery in connection with a civil

action against a licensed psychologist

in section 12-245-307(2),

C.R.S., this Rule, and the current CPD Manual.

As set forth in section 12-245-307(5)(a), C.R.S., records of assessment or

other documentation developed or submitted in connection with the

continuing professional development program are confidential and not

subject to inspection by the public or discovery in connection with a civil

action against a licensed psychologist. The records or documents shall be

used only by the board for the purpose of determining whether a licensed

psychologist is maintaining continuing professional development

necessary to engage in the profession.

The current CPD Manual will set forth the documentation methods and

standards for compliance with this Rule.

Military Exemption. Pursuant to section 12-20-302, C.R.S., a licensed

psychologist who has been called to federally funded active duty for more than

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120 days for the purpose of serving in a war, emergency, or contingency may

request an exemption from continuing professional development requirements for

the renewal, reinstatement, or reactivation of their license for the two-year

renewal period that falls within the period of service or within six (6) months

following the completion of service.

Military exemptions must be approved by the DPO. A licensed

psychologist seeking a military exemption shall submit a request in writing

with evidence that their military service meets the criteria established in

section 12-20-302, C.R.S.

After being granted a military exemption, in order to complete the renewal

process, the licensed psychologist shall attest to their military exemption.

Records Retention. A licensed psychologist shall retain documentation of

compliance for a minimum of five (5) years from the license expiration date for

the renewal cycle during which PDH were accrued.

Non-Compliance

tion 12-20-302, C.R.S.

After being granted a military exemption, in order to complete the renewal

process, the licensed psychologist shall attest to their military exemption.

Records Retention. A licensed psychologist shall retain documentation of

compliance for a minimum of five (5) years from the license expiration date for

the renewal cycle during which PDH were accrued.

Non-Compliance. Falsifying an attestation or other documentation regarding a

licensed psychologist’s compliance with continuing professional development

requirements constitutes the falsification of information in an application and may

be grounds for discipline pursuant to section 12-245-224(1)(s), C.R.S.

Reinstatement and Reactivation. A licensed psychologist seeking to reinstate or

reactivate a license shall meet continuing professional development

requirements detailed in Rule 1.13 and Rule 1.21.

1.21 INACTIVE LICENSE STATUS AND REACTIVATION OF A LICENSE

Inactive Status. Pursuant to section 12-20-203, C.R.S., a licensed psychologist

may apply to the Board to be transferred to an inactive status. The holder of an

inactive license shall not be required to comply with the continuing professional

development requirements for renewal so long as they remain inactive.

During such time as a licensed psychologist remains in an inactive status,

they shall not perform those acts restricted to active licensed

psychologists pursuant to section 12- 245-303, C.R.S. The Board shall

retain jurisdiction over inactive psychologists for the purposes of

disciplinary action pursuant to section 12-245-222(1)(d), C.R.S.

Practicing with an inactive license shall constitute unlicensed practice and,

therefore, may be grounds for disciplinary or injunctive action, up to and

including revocation.

Application Requirements. To be considered for licensure reactivation, an

applicant must submit a completed reactivation application form and the

reactivation fee.

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ctive license shall constitute unlicensed practice and,

therefore, may be grounds for disciplinary or injunctive action, up to and

including revocation.

Application Requirements. To be considered for licensure reactivation, an

applicant must submit a completed reactivation application form and the

reactivation fee.

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Required Statements. Each applicant for reinstatement shall certify the following:

Every license, certificate, listing, or registration to practice psychology held

by applicant is in good standing;

Applicant has reported to the board any injunction or disciplinary action

completed or pending against their license, certificate, registration, or

listing to practice psychology or psychotherapy;

Applicant has reported to the board any malpractice judgment against

them, any settlement of a malpractice action or claim against them, and

any malpractice action or claim pending against them in which the

malpractice alleged relates to their practice of psychology or

psychotherapy;

Applicant has reported to the board any inquiry/complaint pending,

investigation being conducted by, or disciplinary proceeding pending

before the licensing, grievance, or disciplinary board of any jurisdiction in

which they are licensed, certified, registered, or listed to practice

psychology or psychotherapy in which the complaint, investigation, or

proceeding concerns their practice of psychology or psychotherapy.

Pending Discipline or Complaints. The Board may decline to issue a license to an

applicant for reactivation if disciplinary action is pending or if there is an

unresolved complaint.

Continuing Professional Competence. Pursuant to section 12-245-307, C.R.S,

effective September 1, 2017, a licensed psychologist shall complete continuing

professional development in order to reactivate a license.

Pending Discipline or Complaints. The Board may decline to issue a license to an

applicant for reactivation if disciplinary action is pending or if there is an

unresolved complaint.

Continuing Professional Competence. Pursuant to section 12-245-307, C.R.S,

effective September 1, 2017, a licensed psychologist shall complete continuing

professional development in order to reactivate a license.

An applicant for reactivation must comply with all continuing professional

development requirements pursuant to Rule 1.20 within the two years

immediately preceding the application receipt date.

Criteria. The Board has established the following criteria for determining whether

an applicant for reactivation has demonstrated their continued professional

competence as required by section 12-245-205(3), C.R.S. An applicant must

meet all applicable criteria to establish their continued professional competence.

License Inactive More Than Two Years. An applicant whose license has

been inactive more than two years shall pass a Board developed

jurisprudence examination and demonstrate their continued professional

competence by either:

A written statement detailing work experience related to the

practice of psychology during the time the license has been

expired. If work experience was in another jurisdiction(s),

verification of licensure from each jurisdiction(s) is required; or

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and demonstrate their continued professional

competence by either:

A written statement detailing work experience related to the

practice of psychology during the time the license has been

expired. If work experience was in another jurisdiction(s),

verification of licensure from each jurisdiction(s) is required; or

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Completion of an average of twenty professional development

hours (PDH) pursuant to section 12-245-307(2)(b), C.R.S., and

Rule 1.20, for each year the license has been expired (1.67 for

each month); or

Retaking and passing the Examination for Professional Practice in

Psychology (EPPP) national examination.

Any other means approved by the Board.

1.22 REQUIRED DISCLOSURE TO PATIENTS – CONVICTION OF OR DISCIPLINE

BASED ON SEXUAL MISCONDUCT (§12-30-115 C.R.S.)

On or after March 1, 2021, a licensee, as defined in Rule 1.1(E), shall disclose to

a patient, as defined in section 12-30-115(1)(a), C.R.S., instances of sexual

misconduct, including a conviction or guilty plea as set forth in section 12-30-

115(2)(a), C.R.S., or final agency action resulting in probation or limitation of

licensee’s ability to practice as set forth is section 12-30-115(2)(b), C.R.S.

Form of Disclosure: The written disclosure shall include all information specified

in section 12-30-115(3), C.R.S., and consistent with the sample model disclosure

form as set forth in Appendix A to these rules.

The patient must, through their signature on the disclosure form,

acknowledge the receipt of the disclosure and agree to treatment with the

licensee.

This disclosure shall be separate and apart from the mandatory disclosure

required pursuant to section 12-245-216, C.R.S.

Timing of Disclosure: This disclosure shall be provided to a patient the same day

the patient schedules a professional services appointment with the provider

nature on the disclosure form,

acknowledge the receipt of the disclosure and agree to treatment with the

licensee.

This disclosure shall be separate and apart from the mandatory disclosure

required pursuant to section 12-245-216, C.R.S.

Timing of Disclosure: This disclosure shall be provided to a patient the same day

the patient schedules a professional services appointment with the provider. If an

appointment is scheduled the same day that services will be provided, or if an

appointment is not required such as in an inpatient facility, the disclosure must be

provided in advance of the treatment.

The written disclosure and agreement to treatment must be completed

prior to each treatment appointment with a patient, unless the treatment

will occur in a series over multiple appointments or a patient schedules

follow-up treatment appointments.

For treatment series or follow-up treatment appointments, one disclosure

prior to the first appointment is sufficient, unless the information the

provider is required to disclose pursuant to section 12-30-115, C.R.S., has

changed since the most recent disclosure, in which case an updated

disclosure must be provided to a patient and signed before treatment may

continue.

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As set forth in section 12-30-115(3)(e), C.R.S., the requirement to disclose the

conviction, guilty plea, or agency action ends when the provider has satisfied the

requirements of the probation or other limitation and is no longer on probation or

otherwise subject to a limitation on the ability to practice the provider’s

profession.

A provider need not make the disclosure required by this section before providing

professional services to the patient if any of the following applies as set forth in

section 12-30-115(4), C.R.S.:

provider has satisfied the

requirements of the probation or other limitation and is no longer on probation or

otherwise subject to a limitation on the ability to practice the provider’s

profession.

A provider need not make the disclosure required by this section before providing

professional services to the patient if any of the following applies as set forth in

section 12-30-115(4), C.R.S.:

The patient is unconscious or otherwise unable to comprehend the

disclosure and sign an acknowledgment of receipt of the disclosure

pursuant to section 12-30-115(3)(d), C.R.S., and a guardian of the patient

is unavailable to comprehend the disclosure and sign the

acknowledgement;

The visit occurs in an emergency room or freestanding emergency

department or the visit is unscheduled, including consultations in inpatient

facilities; or

The provider who will be treating the patient during the visit is not known

to the patient until immediately prior to the start of the visit.

A provider who does not have a direct treatment relationship or have direct

contact with the patient is not required to make the disclosure required by this

section.

1.23 CONCERNING HEALTH CARE PROVIDER DISCLOSURES TO CONSUMERS

ABOUT THE POTENTIAL EFFECTS OF RECEIVING EMERGENCY OR

NONEMERGENCY SERVICES FROM AN OUT-OF-NETWORK PROVIDER

This rule is promulgated pursuant to sections 12-20-204, 12-30-112, and 12-245-

204(4)(a), C.R.S., in consultation with the Commissioner of Insurance and the State

Board of Health. The purpose of this rule is to establish requirements for health care

providers to provide disclosures to covered persons who are utilizing a health benefit

plan about the potential of balance billing when receiving post-stabilization services or

covered non-emergency services from an out-of-network provider at an in-network

facility. This rule applies to health care providers

ate

Board of Health. The purpose of this rule is to establish requirements for health care

providers to provide disclosures to covered persons who are utilizing a health benefit

plan about the potential of balance billing when receiving post-stabilization services or

covered non-emergency services from an out-of-network provider at an in-network

facility. This rule applies to health care providers. Balance billing by a health care

provider is only permitted when the criteria established in Colorado law, including but

not limited to, sections 12-30-112 and 12-30-113 C.R.S., are met.

Definitions, for purposes of this rule, are as follows:

“Ancillary Services” as defined in section 12-30-112(1)(a), C.R.S.

“Balance Bill” and “Balance Billing” as defined in section 10-16-704(19)(c),

C.R.S.

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“Covered Non-emergency Services” means services that are not

emergency services as defined in section 10-16-704(19)(e), C.R.S., are

services covered by a covered person’s health benefit plan, and are not

ancillary services as defined in section 12-30-112(1)(a), C.R.S.

“Covered Person” as defined by section 10-16-102(15), C.R.S.

“Health Benefit Plan” as defined by section 10-16-102(32), C.R.S.

“Health Care Provider” means “provider,” as defined in section 10-16-

102(56), C.R.S.

“In-Network Facility” means a facility, either within or outside of Colorado,

that, under a contract with a carrier or with its contractor or subcontractor,

has agreed to provide health-care services to covered persons with an

expectation of receiving payment, other than coinsurance, copayments, or

deductibles, directly or indirectly, from the carrier.

“Out-of-Network Provider” means a Health Care Provider who is not a

“Participating Provider.”

“Participating Provider” as defined in section 10-16-102(46), C.R.S.

s contractor or subcontractor,

has agreed to provide health-care services to covered persons with an

expectation of receiving payment, other than coinsurance, copayments, or

deductibles, directly or indirectly, from the carrier.

“Out-of-Network Provider” means a Health Care Provider who is not a

“Participating Provider.”

“Participating Provider” as defined in section 10-16-102(46), C.R.S.

10.

“Post-Stabilization Services” means covered services related to an

emergency medical condition, as defined in section 10-16-704(19)(d),

C.R.S., that are provided once the criteria set forth in section 10-16-

704(19)(e)(III) are met.

Disclosure requirements.

An Out-of-Network Provider may balance bill a Covered Person for (a)

Post-Stabilization Services in accordance with section 10-16-704, C.R.S.,

and (b) Covered Non-Emergency Services provided in an In-Network

Facility that are not Ancillary Services, but only if the Out-of-Network

Provider meets the requirements set forth in section 12-30-112(3.5),

C.R.S.

If a Covered Person may incur a claim for Post-Stabilization Services or

Covered Non-Emergency Services from an Out-of-Network Provider, the

Out-of-Network Provider shall complete and provide the notice contained

in Appendix “B” to these rules or a similar disclosure which complies with

the requirements set forth in section 12-30-112(3.5), C.R.S.

Such notice must be provided in the 15 most common languages in

Colorado, which, for purposes of this regulation, are English, Spanish,

Vietnamese, Chinese, Korean, Russian, Amharic, Arabic, German,

French, Nepali, Tagalog, Japanese, Cushite, Persian.

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ith

the requirements set forth in section 12-30-112(3.5), C.R.S.

Such notice must be provided in the 15 most common languages in

Colorado, which, for purposes of this regulation, are English, Spanish,

Vietnamese, Chinese, Korean, Russian, Amharic, Arabic, German,

French, Nepali, Tagalog, Japanese, Cushite, Persian.

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If applicable and in addition to their responsibilities under this Rule, Health Care

Providers shall also comply with the “No Surprises Act,” 42 U.S.C.A. § 300gg-

111, Pub.L 116-260, as amended.

Noncompliance with this Rule may result in the imposition of any of discipline

made available by section 12-245-224(1)(b), C.R.S.

1.24 CONCERNING THE AUTHORITY OF A LICENSED PSYCHOLOGIST TO

PRESCRIBE PSYCHOTROPIC MEDICATION FOR THE TREATMENT OF MENTAL

HEALTH DISORDERS

This Rule is promulgated pursuant to sections 12-20-204, 12-245-204(4)(a), 12-245-

224, 12-30-109, 12-245-301, 12-245-302, and 12-245-309, C.R.S., in consultation with

the Colorado Medical Board, to further clarify statutory language and establish

application requirements for attaining a Prescription Certificate for a licensed

psychologist in Colorado.

As used herein, the following terms are defined as follows:

In accordance with section 12-245-301(7) C.R.S., a “Prescribing

Psychologist” means a licensed psychologist who holds a prescription

certificate.

”Psychotropic Medication” has the same meaning as defined in sections

12-245-301(10)(a) and (b), C.R.S.

In accordance with sections 12-245-301(11) C.R.S., “Telepsychology”

means the provision of psychological services using telecommunications

technologies.

APPLICATION

An applicant for a prescription certificate shall submit a complete

application on a form approved by the Board. The applicant is responsible

to ensure that the application is complete and timely and that all

application fees are paid. Applicant and application must demonstrate the

following:

”

means the provision of psychological services using telecommunications

technologies.

APPLICATION

An applicant for a prescription certificate shall submit a complete

application on a form approved by the Board. The applicant is responsible

to ensure that the application is complete and timely and that all

application fees are paid. Applicant and application must demonstrate the

following:

Applicant holds an active and unrestricted license to practice

psychology in Colorado;

Has commercial professional liability insurance as outlined in

section 12-245-309, C.R.S., and provides an attestation to the

Board to reflect this requirement

Has successfully completed all educational, examination,

supervision, and practice requirements outlined in section 12-245-

309, C.R.S.

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PEER REVIEW

As referenced in section 12-245-309(a)(V), C.R.S., the applicant has successfully

undergone a process of independent peer review set forth in Rule of the Board and

approved by the Colorado Medical Board:

Panel membership. The applicant for a prescription certificate shall

successfully complete a process of independent peer review within sixty

(60) days that meets the requirements set forth below and will submit

successful completion of independent peer review as part of the

application process on a form approved by the Board.

The applicant shall ensure the peer review panel that they use shall

consist of three members from at least two of the following

professions and categories:

(1)

Prescribing psychologists or licensed psychologists with

specialized training and experience in psychopharmacology;

(2)

Licensed, board-certified psychiatrists, other physicians,

nurse practitioners or physician assistants with specialized

training and experience in psychopharmacology;

l that they use shall

consist of three members from at least two of the following

professions and categories:

(1)

Prescribing psychologists or licensed psychologists with

specialized training and experience in psychopharmacology;

(2)

Licensed, board-certified psychiatrists, other physicians,

nurse practitioners or physician assistants with specialized

training and experience in psychopharmacology;

(3)

Doctoral level licensed pharmacists or pharmacist clinicians

with specialized training and experience in

psychopharmacology.

A panel member shall not be a member of the applicant’s family or

household, shall not be in a prohibited dual relationship with the

applicant or a member of the applicant’s family or household, shall

not have supervised the applicant, and shall not have a conflict of

interest otherwise not stated.

No panel member may be a psychologist enrolled in a

psychopharmacology training program.

Review Process.

Each panel member shall examine at least ten (10) randomly

selected charts of patients treated by the applicant during the

required supervised period outlined in statute and any approved

extensions. The applicant shall be solely responsible for obtaining

the patient charts for peer review and providing them for peer

review. The charts shall be reviewed to determine whether the

following information is timely, accurately, and properly recorded:

(1)

A full medical history and family history;

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(2)

A mental status examination and complete differential

diagnosis of the patient by the conditional prescribing

psychologist

(3)

Risk factors for the diagnostic condition were identified,

including absence of drug, alcohol, suicide and homicide;

(4)

Drug and food allergies;

(5)

Patient medications;

(6)

Patient education on prescription, including evidence of

informed consent to treatment;

(7)

Appropriate laboratory tests ordered and reviewed;

(8)

The patient’s diagnosis;

tient by the conditional prescribing

psychologist

(3)

Risk factors for the diagnostic condition were identified,

including absence of drug, alcohol, suicide and homicide;

(4)

Drug and food allergies;

(5)

Patient medications;

(6)

Patient education on prescription, including evidence of

informed consent to treatment;

(7)

Appropriate laboratory tests ordered and reviewed;

(8)

The patient’s diagnosis;

(9)

Adequate dosing requirements for prescription;

(10)

Treatment, including psychopharmacotherapy and

psychotherapy, adverse effects from prescriptions,

documentation of outcome measures for prescriptions;

(11)

Progress notes;

(12)

A follow-up plan, including a discharge plan;

(13)

Written documentation that the Colorado Prescription Drug

Monitoring Program (PDMP) was checked before a

controlled substance prescription was written; and

(14)

Documentation of collaboration with the physician who

oversees the patient’s general medical care as required by

law.

The peer review panel shall complete an evaluation form approved

by the Board, which shall certify whether the charts reviewed are in

compliance and are satisfactory, and shall provide the form back to

the applicant to be included as part of their application process.

PRACTICE REQUIREMENTS

New Prescriptions

A prescribing psychologist shall receive a written electronic

agreement from the patient’s primary treating physician indicating

that the prescription for, or administration of, medication is

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orm back to

the applicant to be included as part of their application process.

PRACTICE REQUIREMENTS

New Prescriptions

A prescribing psychologist shall receive a written electronic

agreement from the patient’s primary treating physician indicating

that the prescription for, or administration of, medication is

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appropriate for that patient before prescribing or administering any

medication.

Medication dosage changes and the discontinuation of any

medications require timely (i.e., 14 days) notification to the primary

care physician by the prescribing psychologist.

If prescribing controlled substances, the prescribing psychologist

must maintain a valid Federal Drug Enforcement Administration

(DEA) registration for the state of Colorado in accordance with DEA

regulations: Title 21, Code of Federal Regulations (CFR), Parts

1300 to 1316, September 25, 2025. Available here:

https://www.ecfr.gov/current/title-21/chapter-II/part-1300.

(1)

This Rule does not incorporate any later amendments or

editions of these federal rules. The Board shall provide the

requester with information on how to obtain a certified copy

of the material incorporated by reference from the agency of

the United States issuing the standards.

(2)

Copies of these rules are available for public inspection, with

additional copies being made available for a reasonable

charge, at the office of the Department of Regulatory

Agencies, located at 1560 Broadway, Denver, CO 80202; or

alternatively, at the Office of the Federal Register, 7 G

Street, NW, Suite A-734, Washington, D.C. 20401.

rom the agency of

the United States issuing the standards.

(2)

Copies of these rules are available for public inspection, with

additional copies being made available for a reasonable

charge, at the office of the Department of Regulatory

Agencies, located at 1560 Broadway, Denver, CO 80202; or

alternatively, at the Office of the Federal Register, 7 G

Street, NW, Suite A-734, Washington, D.C. 20401.

(3)

A prescribing psychologist must furnish the DEA registration

information to the Board in a form and manner as required

by the Board.

A prescribing psychologist, if prescribing controlled substances,

must be enrolled in the Colorado Prescription Drug Monitoring

Program (PDMP) in accordance with section 23.00.00 of Rule 3

CCR 719-1; and must check the PDMP prior to writing a

prescription for a controlled substance.

A prescribing psychologist shall only prescribe psychotropic

medications that are consistent with the prescribing psychologist’s

education, training, experience, and competence.

Telepsychology

In accordance with section 12-245-309(5)(a)(I), C.R.S., a

prescribing psychologist may prescribe psychotropic medications

through the use of telepsychology.

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A prescribing psychologist must be licensed in Colorado and have

a Colorado prescription certificate to prescribe to a patient whose

originating site, as defined in section 10-16-123(4)(b), C.R.S., is in

Colorado.

Further, a prescribing psychologist must adhere to the standard of

care for both telepsychology and psychology prescribing in

Colorado and the state where the client is receiving treatment.

Prescribing psychologists must be licensed by the Colorado State

Board of Psychologist Examiners when providing telepsychology

services to clients whose originating site is in Colorado as defined

in section 10-16-123(4)(b), C.R.S.

hologist must adhere to the standard of

care for both telepsychology and psychology prescribing in

Colorado and the state where the client is receiving treatment.

Prescribing psychologists must be licensed by the Colorado State

Board of Psychologist Examiners when providing telepsychology

services to clients whose originating site is in Colorado as defined

in section 10-16-123(4)(b), C.R.S.

Prescribing psychologists must follow all applicable federal and

state laws regarding prescribing controlled substances and other

medications.

DISCIPLINE

It shall be a prohibited activity under section 12-245-224, C.R.S. for an applicant,

candidate, or licensee to:

Prescribe, distribute, or give to a family member or to oneself, except on

an emergency basis, any controlled substance as defined in section 18-

18-204, C.R.S., or as contained in schedule II of 21 U.S.C. sec. 812, as

amended;

Accept any direct or indirect benefit from a pharmaceutical manufacturer

or pharmaceutical representative for prescribing a specific medication to a

patient. For the purposes of this section, a direct or indirect benefit does

not include a benefit offered to an applicant, candidate, or licensee

regardless of whether the specific medication is being prescribed;

Administer, dispense, or prescribe any habit-forming drug or any

controlled substance, as defined in section 18-18-102(20), C.R.S., other

than in the course of legitimate professional practice, which includes the

recommendation, administration, or dispensation of medical marijuana;

Violate a provision of section 12-30-109, C.R.S.

USE OF BENZODIAZEPINES

Basis: The basis for the Board’s promulgation of these rules and regulations are

sections 12-20- 204(1), 12-240-106(1)(a), and 12-240-123, C.R.S. The specific statutory

authority for the promulgation of this Rule is section 12-30-109(6), C.R.S.

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Violate a provision of section 12-30-109, C.R.S.

USE OF BENZODIAZEPINES

Basis: The basis for the Board’s promulgation of these rules and regulations are

sections 12-20- 204(1), 12-240-106(1)(a), and 12-240-123, C.R.S. The specific statutory

authority for the promulgation of this Rule is section 12-30-109(6), C.R.S.

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Scope: The purpose of these rules and regulations is to implement section 12- 30-

109(6), C.R.S., related to requirements for prescribing benzodiazepines to patients who

have not previously been prescribed benzodiazepines within the last twelve (12)

months.

Licensees must limit any prescription for a continuous benzodiazepine to a

thirty (30) day supply, for any patient who has not been prescribed a

benzodiazepine in the last twelve (12) months.

Prior to prescribing a benzodiazepine for a condition that is not exempt

under section 12-280-404(4)(a.5), C.R.S., a licensee must comply with the

requirements of section 12- 280-404(4), C.R.S.

The limitation stated in section (F)(1) of this Rule does not apply to

patients for whom licensees prescribe benzodiazepines for the following

conditions:

Epilepsy;

A seizure, a seizure disorder, or a suspected seizure disorder;

Spasticity;

Alcohol withdrawal; or

A neurological condition, including a post-traumatic brain injury or

catatonia.

These rules do not require or encourage abrupt discontinuation, limitation,

or withdrawal of benzodiazepines. Licensees are expected to follow

generally accepted standards of medical practice, based on an individual

patient’s needs, in tapering benzodiazepine prescriptions.

CONTINUING EDUCATION

ithdrawal; or

A neurological condition, including a post-traumatic brain injury or

catatonia.

These rules do not require or encourage abrupt discontinuation, limitation,

or withdrawal of benzodiazepines. Licensees are expected to follow

generally accepted standards of medical practice, based on an individual

patient’s needs, in tapering benzodiazepine prescriptions.

CONTINUING EDUCATION

In addition to the continuing professional development requirements

contained in section 1.20, including the forty (40) hours of continuing

education required in section 1.20(C)(1)(b) herein, prescribing

psychologists shall complete an additional forty (40) hours of continuing

education related to the practice of prescribing psychology during each

two-year renewal cycle, as required by section 12-245-309(2)(b)(III)

C.R.S.

To qualify for continuing education credit, a prescribing psychologist must

select learning activities as detailed in section 12-245-307(2)(b), C.R.S.

and must include one or more of the activities, in any combination, cited in

section 1.20(C)(4) of these Rules.

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One (1) continuing education hour is equivalent to one (1) professional

development hour (PDH). PDH are equivalent to clock hours.

These continuing education hours must include professional development

in psychopharmacology and/or pharmacology education for psychologists.

Approved course topics may include, but are not limited to:

Basic neuroscience;

Neurochemistry;

Pharmacological concepts;

Treatment of specific behavioral disorders;

Medication management;

Medication impact and adverse effects;

Substance use;

Treatment-resistant depression;

Psychedelic drugs;

Adult Attention Deficit Hyperactivity Disorder (ADHD); and

Managing antipsychotic side effects.

These required continuing education courses must be at an appropriate

level for professional training in psychology prescribing.

behavioral disorders;

Medication management;

Medication impact and adverse effects;

Substance use;

Treatment-resistant depression;

Psychedelic drugs;

Adult Attention Deficit Hyperactivity Disorder (ADHD); and

Managing antipsychotic side effects.

These required continuing education courses must be at an appropriate

level for professional training in psychology prescribing.

If a prescribing psychologist specializes in treating children, a minimum of

ten (10) hours of continuing education must be directly related to

prescribing psychotropic medications for children.

If a prescribing psychologist specializes in treating persons who are over

65 years of age, a minimum of ten (10) hours of continuing education must

be directly related to prescribing psychotropic medications for older

persons.

A minimum of two (2) of the required hours of continuing education shall

include content on ethics, as related to the practice of prescribing

psychology.

10.

Individuals who first become licensed as a prescribing psychologist during

the two-year renewal cycle will be considered to have satisfied these

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continuing education requirements for the remainder of the cycle in which

their license was granted.

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APPENDIX A

MODEL SEXUAL MISCONDUCT DISCLOSURE STATEMENT

DISCLAIMER: This Model Sexual Misconduct Disclosure Statement is to be used as a

guide only and is aimed only to assist the provider in complying with section 12-30-115,

C.R.S., and Rule 1.22. As a licensed, registered, and/or certified health care provider in

the State of Colorado, you are responsible for ensuring that you are in compliance with

state statutes and rules

NDUCT DISCLOSURE STATEMENT

DISCLAIMER: This Model Sexual Misconduct Disclosure Statement is to be used as a

guide only and is aimed only to assist the provider in complying with section 12-30-115,

C.R.S., and Rule 1.22. As a licensed, registered, and/or certified health care provider in

the State of Colorado, you are responsible for ensuring that you are in compliance with

state statutes and rules. While the information below must be included in your Sexual

Misconduct Disclosure Statement pursuant to section 12-30-115, C.R.S., you may to

include additional information that specifically applies to your situation and practice.

Provider, as defined in Rule 1.1E, information, including, at a minimum: name,

business address, and business telephone number.

A listing of any final convictions of or a guilty plea to a sex offense, as defined in

section 16-11.7-102(3), C.R.S.

For each such conviction or guilty plea, the provider shall provide, at a minimum:

The date that the final judgment of conviction or guilty plea was entered;

The nature of the offense or conduct that led to the final conviction or

guilty plea;

The type, scope, and duration of the sentence or other penalty imposed,

including whether:

The provider entered a guilty plea or was convicted pursuant to a

criminal adjudication;

The provider was placed on probation and, if so, the duration and

terms of the probation and the date the probation ends; and

The jurisdiction that imposed the final conviction or issued an order

approving the guilty plea.

A listing of any final agency action by a professional regulatory board or agency

that results in probationary status or other limitation on the provider’s ability to

practice if the final agency action is based in whole or in part on:

a conviction for or a guilty plea to a sex offense, as defined in section 16-

11.7-102(3), C.R.S

inal conviction or issued an order

approving the guilty plea.

A listing of any final agency action by a professional regulatory board or agency

that results in probationary status or other limitation on the provider’s ability to

practice if the final agency action is based in whole or in part on:

a conviction for or a guilty plea to a sex offense, as defined in section 16-

11.7-102(3), C.R.S. or a finding by the professional regulatory board or

Director that the provider committed a sex offense, as defined in as

defined in section 16-11.7-102(3), C.R.S.; or

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a finding by a professional regulatory board or agency that the provider

engaged in unprofessional conduct or other conduct that is grounds for

discipline under the part or article of Title 12 of the Colorado Revised

Statutes that regulates the provider’s profession, where the failure or

conduct is related to, includes, or involves sexual misconduct that results

in harm to a patient or presents a significant risk of public harm to patients.

For each such final agency action by a professional regulatory board or agency

the provider shall provide, at a minimum:

The type, scope, and duration of the agency action imposed, including

whether:

the regulator and licensee entered into a stipulation;

the agency action resulted from an adjudicated decision;

the provider was placed on probation and, if so, the duration and

terms of probation; and

the professional regulatory board or agency imposed any limitations

on the provider’s practice and, if so, a description of the specific

limitations and the duration of the limitations.

The nature of the offense or conduct, including the grounds for probation

or practice limitations specified in the final agency action;

The date the final agency action was issued;

The date the probation status or practice limitation ends; and

ncy imposed any limitations

on the provider’s practice and, if so, a description of the specific

limitations and the duration of the limitations.

The nature of the offense or conduct, including the grounds for probation

or practice limitations specified in the final agency action;

The date the final agency action was issued;

The date the probation status or practice limitation ends; and

The contact information for the professional regulatory board or agency

that imposed the final agency action on the provider, including information

on how to file a complaint.

Sample Signature Block

I have received and read the sexual misconduct disclosure by [Provider Name] and I

agree to treatment by [Provider Name].

_______________________________________________________________

Print Patient Name

_______________________________________________________________

Patient or Responsible Party’s Signature

Date

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If signed by Responsible Party (parent, legal guardian, or custodian), print Responsible

Party’s name and relationship to patient:

_______________________________________________________________

Print Responsible Party Name

Print Relationship to Patient

_______________________________________________________________

Licensee Signature

Date

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APPENDIX B

BALANCE BILLING NOTICE

PATIENT RIGHTS INFORMATION

Check the appropriate box:

☐

Your provider is proposing to use an out-of-network care provider in

delivering your health care service(s). This facility is in-network with your

insurance but there may be care providers involved in your care that are

out-of-network.

☐

Your provider is proposing to deliver post-stabilization care at an out-of-

network facility. You have received emergency services at the out-of-

network facility and are now stabilized, but you may require additional

health care services

ing your health care service(s). This facility is in-network with your

insurance but there may be care providers involved in your care that are

out-of-network.

☐

Your provider is proposing to deliver post-stabilization care at an out-of-

network facility. You have received emergency services at the out-of-

network facility and are now stabilized, but you may require additional

health care services.

You are not required to consent to receive these services from the out-of-network care

provider or continue to receive post-stabilization care at an out-of-network facility. If you

choose to proceed with the proposed out-of-network care provider or facility you may be

billed for costs detailed in the Good Faith Estimate below. The additional costs you pay

may not accrue toward insurance cost sharing or deductibles.

You may choose to use an in-network provider from the list below or you may choose to

transfer your care to an in-network facility for post-stabilization services. If you choose

to proceed with an in-network provider or transfer to an in-network facility, the cost will

not exceed the amount allowed by your insurance plan.

You chose to receive this Notice ☐ electronically or ☐ in paper form.

This notice must have been provided to you, either in paper or electronically, per your

preference within the following timeframes:

At least seventy-two hours in advance of the date of services, if the

appointment was scheduled at least seventy-two hours in advance;

At least three hours before the scheduled appointment, if the appointment

was made less than seventy-two hours in advance.

This is not a contract for services. Your provider is required to retain this form for seven

years.

This form must be available to you in the 15 languages most common to the geographic

region where your provider is located, which include English, Spanish, Vietnamese,

Chinese, Korean, Russian, Amharic, Arabic, German, French, Nepali, Tagalog,

Japanese, Cushite, and Persian.

ty-two hours in advance.

This is not a contract for services. Your provider is required to retain this form for seven

years.

This form must be available to you in the 15 languages most common to the geographic

region where your provider is located, which include English, Spanish, Vietnamese,

Chinese, Korean, Russian, Amharic, Arabic, German, French, Nepali, Tagalog,

Japanese, Cushite, and Persian.

CODE OF COLORADO REGULATIONS

3 CCR 721-1

State Board of Psychologists Examiners

BILLING ADVISEMENT

(choose applicable billing scenario)

☐

Out-of-Network Provider at In-Network Facility

Your provider is proposing to use an out-of-network care provider in delivering your

service(s). That out-of-network provider is/are:

[PROVIDER NAME]

Description of service(s) to be provided by an in-network facility by an out-of-network

provider:

[SERVICE]

You scheduled the service(s) on [DATE] at [TIME]. You are planning to receive the

service(s) stated above on [DATE] at [TIME]

Do you need prior authorization from your insurance company for the service(s)

provided at this facility?

[Y / N]

Good Faith Estimate for the total cost of the service(s) to you, the patient:

[$]

Does this facility employ in-network care providers who provide the service(s) detailed

above?

[Y / N]

If Yes, the in-network care provider(s) who provide the service(s) are:

[PROVIDER NAME]

NOTE: If there is no in-network provider to provide the service(s) at this in-network

facility you cannot be balanced billed for the services provided by the out-of-network

provider. OR

☐

Post-Stabilization Services

Your provider is proposing to deliver post-stabilization care at an out-of-network facility.

The out-of-network facility is and/or the provider(s) is/are:

[FACILITY/PROVIDER NAME]

CODE OF COLORADO REGULATIONS

3 CCR 721-1

State Board of Psychologists Examiners

n-network

facility you cannot be balanced billed for the services provided by the out-of-network

provider. OR

☐

Post-Stabilization Services

Your provider is proposing to deliver post-stabilization care at an out-of-network facility.

The out-of-network facility is and/or the provider(s) is/are:

[FACILITY/PROVIDER NAME]

CODE OF COLORADO REGULATIONS

3 CCR 721-1

State Board of Psychologists Examiners

Description of post-stabilization service(s) to be provided by an out-of-network facility or

provider:

[SERVICE]

You scheduled the service(s) on [DATE] at [TIME]. You are planning to receive the

service(s) stated above on [DATE] at [TIME].

Good Faith Estimate for the total cost of the service(s) to you, the patient:

[$]

I [PATIENT NAME] received this form at [TIME] on [DATE].

___________________________________________

SIGNATURE OF PATIENT

[TIME] and [DATE]

CODE OF COLORADO REGULATIONS

3 CCR 721-1

State Board of Psychologists Examiners

Editor’s Notes

History

Entire rule emer. rule eff. 01/01/2012.

Entire rule eff. 02/01/2012.

Rule 12 eff. 03/16/2016.

Rules 13, 20, 21 emer. rules eff. 04/07/2017.

Rules 13, 20, 21 eff. 07/30/2017.

Rules 1.6 A, 1.6 B.2, 1.7 B.4, 1.14 A.2-5.b, 1.16 A emer. rules eff. 10/02/2020.

Rules 1.6 A, 1.6 B.2, 1.7 B.4, 1.12, 1.14 A.2-5.b, 1.16 A, 1.18 E, 1.22, Appendix A eff.

11/30/2020.

Rules 1.6 A, 1.12 C-D, 1.22, Appendix A eff. 05/30/2021.

Rule 1.8 B eff. 11/14/2021.

Rule 1.12 eff. 09/30/2022.

Rules 1.23, 1.24 emer. rules eff. 10/07/2022.

Rules 1.23-1.25, Appendix B eff. 11/30/2022.

Rule 1.24 emer. rule eff. 10/06/2023.

Rules 1.23, 1.24 repealed eff. 11/30/2023. Rule 1.24 eff. 11/30/2023.

Rules 1.6 C.2, 1.7 B, 1.7 C.1, 1.10, 1.11, 1.12 C.1.a(2)(i), 1.12 C.1.a(3), 1.12 C.2.a,

1.12 C.4, 1.13, 1.14 A.2, 1.14 B.2, 1.14 B.2.c, 1.14 C.1.f, 1.14 C.3.a(2),(3), 1.14

C.3.b, 1.16 A, 1.16 D,E, 1.20, 1.20 A.2, 1.20 B.1, 1.20 B.3, 1.20 C.1.A(1),(2),

1.20 C.2, 1.20 C.3, 1.20 C.4, 1.20 E, 1.21 A, 1.21 C, 1.21 F, 1.22 B.1 eff.

03/30/2025.

Rules 1.12 D, 1.14 D.1, 1.23, Appendix B eff. 09/30/2025

23.

Rules 1.6 C.2, 1.7 B, 1.7 C.1, 1.10, 1.11, 1.12 C.1.a(2)(i), 1.12 C.1.a(3), 1.12 C.2.a,

1.12 C.4, 1.13, 1.14 A.2, 1.14 B.2, 1.14 B.2.c, 1.14 C.1.f, 1.14 C.3.a(2),(3), 1.14

C.3.b, 1.16 A, 1.16 D,E, 1.20, 1.20 A.2, 1.20 B.1, 1.20 B.3, 1.20 C.1.A(1),(2),

1.20 C.2, 1.20 C.3, 1.20 C.4, 1.20 E, 1.21 A, 1.21 C, 1.21 F, 1.22 B.1 eff.

03/30/2025.

Rules 1.12 D, 1.14 D.1, 1.23, Appendix B eff. 09/30/2025.

Rules 1.20, 1.24 eff. 05/30/2026

Annotations

Rules 1.12 C, 1.12 D, 1.22 E.4 (adopted 10/02/2020) were not extended by Senate Bill

21-152 and therefore expired 05/15/2021.

Rules 1.24 B. and 1.24 C. (adopted 10/07/2022) were not extended by Senate Bill 23-

102 and therefore expired 05/15/2023.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.