Practice Sample Registration & Coordinator Information

 Practice Sample Submission

Once candidacy* has been established, the next phase is the Practice Sample Submission. Registration for the Practice Sample should be completed within 30 days of candidacy, and can be processed either online or mailed into the Central Office.
 
Within one year of Candidacy", Practice Samples are to be submitted to the Practice Sample Coordinator, see below for the Practice Sample Registration Form and the Practice Sample Coordinator Contact Information for each specialty board.
 
*Exception: Clinical Neuropsychology and Forensic Psychology must complete the Written Exam prior to the Practice Sample Stage.

 

 

 

** PLEASE NOTE:  Please use the correct registration form for the board you are applying to**

 

Clinical Child and Adolescent Psychology
Jarrod M. Leffler, PhD, ABPP
200 First Street SW
Rochester, MN 55905
Email: leffler.jarrod@mayo.edu
 
Please refer to the Clinical Child and Adolescent specialty’s portal of the ABPP Web site for instructions for the practice sample and information for preparing the professional statement.
 
 

 

 

Clinical Health Psychology
Erica Jarrett, PhD, ABPP
3027 Mozart Drive
Silver Spring, MD 20904
Phone: 301-295-8761 Fax 301-319-4712
 
Please refer to the Clinical Health specialty’s portal of the ABPP Web site for instructions for the practice sample instructions for the professional data sheet and practice sample contextual information.

 

 

Clinical Neuropsychology

ABCN uses the ScholarOne portal for electronic submission of practice samples and accompanying information (http://mc04.manuscriptcentral.com/practicesamples). Practice samples should be uploaded to the ABCN office through the online ScholarOne portal. If you have any questions or need help please contact the ScholarOne Help Desk at 888-503-1050.

 

Please refer to the Clinical Neuropsychology portal for information regarding

Practice Sample Format, Content, and Submission Instructions.

 

ABCN Oral Examinations are held in Chicago each spring and fall. For information about PS submission deadlines and the upcoming oral examination schedule, please follow the link below

 

ABCN Oral Exam Schedule and Practice Sample Submission Deadlines

 

ABCN Administrator

Phone: 734-936-8269 Fax: 734-936-9761

Email: nunce@med.umich.edu

 

 

Clinical Psychology
Leslie E. Montgomery, PhD, ABPP
10304 Buchmill Drive
Glen Allen, VA 23060
Phone: 804-874-8987
 
Please refer to the Clinical specialty’s portal of the ABPP Web site for instructions for the practice sample and information for preparing the professional statement.
 

 

Cognitive & Behavioral Psychology

Dean McKay, PhD, ABPP

Department of Psychology

Fordham University

441 East Fordham Rd

Bronx, NY 10458

Please refer to the Cognitive & Behavioral specialty’s portal of the ABPP Web site
for instructions for the practice sample.

Practice Sample Registration Form

 

 

Counseling Psychology

Derek Bergeron, PhD, ABPP

1520 W. Colorado Avenue

Colorado Springs, CO 80904

Phone: 979-473-9082

 
Please refer to the Counseling specialty’s portal of the ABPP Web site for instructions for the practice sample.

Practice Sample Registration Form

 

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Couple & Family Psychology
 Allison Waterworth, PsyD, ABPP

2409A Sacramento Street

San Francisco, CA 94115-2225

 
Please refer to the Couple and Family specialty’s portal of the ABPP Web site
for instructions for the practice sample.

Practice Sample Registration Form

 

 

Forensic Psychology

Deborah L. Collins, PsyD, ABPP 

Wisconsin Forensic Unit Safety Building, Room 504

821 W. State Street

Milwaukee, WI 53233

Phone: 414-278-4690 Fax: 414-223-1817

Email: deborah.collins@bciwi.com

 

Please refer to the Forensic specialty’s portal of the ABPP Web site for instructions for the practice sample. 

 

 

Geropsychology

Victor Molinari, Ph.D., ABPP

School of Aging Studies

College of Behavioral and Community Sciences

University of South Florida

13301 Bruce B. Downs Blvd., MHC#1320

Tampa, Florida 33612-3899

Phone: (813) 974-1960 Fax: (813) 974-5788

Email: vmolinari@usf.edu

 
Please refer to the Geropsychology specialty’s portal of the ABPP Web site for instructions for the practice sample and information for preparing the professional statement.

Practice Sample Registration Form

 

 

Group Psychology
Darryl Pure, PhD, ABPP
333 N. Michigan Ave, Ste. 2120
Chicago, IL 60601
Phone: 847-498-6969
 
Include: Four copies of your practice sample and Professional Statement
 
Please refer to the Group specialty’s portal of the ABPP Web site for instructions for the practice sample, and information of oral examination scheduling. The oral examination must be scheduled within six months of notification that the practice sample has been accepted.

Practice Sample Registration Form

 

 

Organizational & Business Consulting Psychology
Dennis Doverspike, PhD, ABPP
University of Akron, Department of Psychology

Akron, OH 44325-4301

Phone: 330-972-8372 Fax: 330-688-6187
 
Please refer to the Organizational and Business Consulting specialty’s portal of the ABPP Web site for instructions for the practice sample.

Practice Sample Registration Form

 

 
Police & Pubic Safety Psychology
Jeni L. McCutcheon, PsyD, MSCP, ABPP

4501 North 22nd Street, Suite 190
Phoenix, AZ  85016  

Phone: 602-368-2526 Fax: 602-368-2527

 
 

 

  

American Board and Academy of Psychoanalysis
John M. Watkins, PhD, ABPP

John M. Watkins, PhD, Inc, A Professional Psychology Corporation
429 Santa Monica Blvd, Suite 200
Santa Monica, CA 90401

Phone: 310-395-6534 Fax: 310-546-3588

Email: johnwatkinsphd@gmail.com

  
 Oral Examination Locations: APA Annual Meeting, Division 39 Spring Meeting, New York,
Possible Candidate Location (Based on Exam Committee Availability).

Practice Sample Registration Form

 

 

Rehabilitation Psychology

Ellen B. Snoxell, PhD, ABPP

2397 Carter Avenue
St. Paul, MN 55108

Phone: 651-634-1934 Fax 651-638-4744

Email: ellenbsnoxell@gillettechildrens.com

 

 Please refer to the Rehabilitation specialty’s portal of the ABPP Web site for instructions for the practice sample and information for preparing the professional statement.

Practice Sample Registration Form

 

 

School Psychology
Tony C. Wu, PhD, ABPP
556 N. Diamond Bar Blvd., #307
Diamond Bar, CA 91765
Phone: 909-753-4986
 
Please refer to the School specialty’s portal of the ABPP Web site for instructions for the practice sample and information for preparing the professional statement.

Practice Sample Registration Form

 

 

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