1. Are you a United States Citizen?A. Yes
2. Are you proficient in basic written and spoken English?A. Yes
The following questions pertain to your licensure and/or certification. Note: The VHA Psychologist must maintain a full, valid and unrestricted independent license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States or the District of Columbia.
3. Do you possess a full, current, and unrestricted license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States (e.g. Puerto Rico), or the District of Columbia? Exception. The Secretary may waive the requirement of licensure for an individual psychologist for a period not to exceed 2 years from the date of employment on the condition that such a psychologist provide care only under the supervision of a psychologist who is so licensed. Non-licensed psychologists who otherwise meet the eligibility requirements may be given a temporary appointment as a graduate psychologist under the authority of 38 U.S.C. § 7405 (a) (1) (D). Failure to obtain licensure during that period is justification for termination of the temporary appointment. This may result in termination of employment.A. Yes
The following question pertains to your degree in Psychology.
4. Do you have a doctoral degree in Psychology from a graduate program in psychology accredited by the American Psychological Association (APA)? The specialty area of the degree must be consistent with the assignment for which the applicant is to be employed. Please remember that a copy of your transcript must be submitted with your application.A. Yes
5. Have you completed a professional psychology internship training program that has been accredited by American Psychological Association (APA)? Exceptions: (1) new VHA psychology internship programs that are in the process of applying for APA accreditation are acceptable in fulfillment of the internship requirement, provided that such programs were sanctioned by the VHA Central Office program Director for Psychology and the VHA Central Office of Academic Affiliations at the time that the individual was an intern and (2) VHA facilities who offered full one-year pre-doctoral internships prior to PL 96-151 (pre-1979) are considered to be acceptable in fulfillment of the internship requirement.A. Yes
6. FOR GS-11: There are no additional requirements beyond the basic requirements. Do you meet the basic requirements for this position? GS-11 staff psychologists at this level diagnose mental disorders, conduct psychological and/or neuropsychological assessments, treat mental disorders through a variety of modalities, and provide adjunctive interventions for treatment of medical disorders. They practice under the close supervision of a licensed psychologist.A. Yes
7. FOR GS-12: Do you possess at least one year of professional psychologist equivalent to the next lower grade level (GS-11). Individuals assigned as GS-12 psychologists may be in the process of obtaining licensure at the independent practice level. If unlicensed, the individual must be supervised by a licensed psychologist and the experience and supervision must meet the standards for psychology licensure.
Assignments - At the GS-12 level, unlicensed psychologists practice under the supervision of a licensed psychologist. They may be assigned to any program area.
8. FOR GS-13: Do you possess at least one year of professional psychologist equivalent to the next lower grade level (GS-12) and hold a full, current, and unrestricted license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States (e.g., Puerto Rico), or the District of Columbia?
Assignments - This is the full performance level for staff psychologists. At this level psychologists are licensed at the doctoral level to practice independently in the provision of psychological services consulting with peers and supervisors as appropriate. They are assigned to any VHA program and setting, including inpatient or outpatient medicine, surgery, mental health, neurology, rehabilitation medicine, geriatrics, Vet Centers, and the VHA National Center for Organizational Development.
9. I certify that, to the best of my knowledge and belief, all of the information included in this questionnaire is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this application and its supporting materials, or in any document or interview associated with the examination process, I may be fined or imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled; I may be denied an appointment; or I may be removed and debarred from Federal service (5 C.F.R. part 731). I understand that any information I give may be investigated and that responding "No" or providing no response to this itemA. Yes, I understand the information provided above and certify that the information provided in this questionnaire is true, correct, and provided in good faith.
Resume Reminder - Your resume must include the following information for each job listed:
Duties (be as detailed as possible)
Month & year start/end dates (e.g. June 2007 to April 2008)
Full-time or part-time status (include hours worked per week)
Top of Form
Bottom of Form
VA HANDBOOK 5005