CCHPTP Program Membership Application
Name of Program
*
Training Institution
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Type of Training Program
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Doctoral
Internship
Postdoc
Web Address (URL) of Training Program
*
Is your program accredited?
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Yes, APA
Yes, CPA
Not accredited
In what health service practice area is your program accredited?
Doctoral Program
Internship Program
Postdoctoral Fellowship
Note:
Accreditation not required for Postdoctoral fellowships, consistent with the Model Licensing Act. Although accreditation not yet required for postdoctoral fellowships,seeking accreditation is highly recommended as a measure of quality, and it is important that all clinical health fellowships clearly indicate in public materials this specialty training.
Training Director
If dual TDs, indicate primary TD, and list secondary under additional Faculty Section
Training Director
*
First Name
Last Name
Training Director Degree
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
-
Country Code
-
Area Code
Phone Number
Designated Training Program Representative
To whom CCHPTP should contact for dues and other correspondence
Name
*
First Name
Last Name
Representative Email
*
example@example.com
Other Faculty Members
Indicate Other Faculty Members and their emails who want to receive communication from CCHPTP
Qualifications
Members of CCHPTP are clinical health psychology doctoral, internship,and post-doctoral programs that produce clinical health psychologists capable of functioning as scientific investigators and as practitioners, consistent with the highest standards of clinical health psychology and consistent with Health Service Psychology guidelines. CCHPTP members adhere to a training model in which all trainees obtain competencies in both conducting empirical research and engaging in practice in clinical health psychology settings.
Program membership Type - Choose One:
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Full Membership
Associate Membership
Full Membership
Full Membership is offered to doctoral, internship, and postdoctoral programs that train health service psychology students with competencies in the science and practice of clinical health psychology, and provide training at the “Major Area of Study” or“Emphasis” levels of the Taxonomy (see below). Doctoral and internship programs must be accredited through APA or CPA for full membership. Program representatives from programs with Full Membership can participate in all aspects of CCHPTP governance, including running for elected office, voting for candidates for office, and voting on initiatives being considered by the organization. Dues Fees: $200.00
Associate Membership
Associate Membership is offered to programs that demonstrate commitment to training health service psychology students with competencies in the science and practice of Clinical Health Psychology, and provide training at the “Experience” or “Exposure” levels of the Taxonomy (see below). Representatives of programs with Associate Membership are welcomed and encouraged to participate in discussion of initiatives being considered by CCHPTP, but cannot participate in CCHPTP governance. CCHPTP encourages Associate Member programs to apply for Full Membership status if they meet criteria over time. Dues Fees: $175.00
Describe your model of training and explain how it assures that all trainees obtain competencies in both conducting empirical research and engaging in clinical practice in health psychology settings
If you want to submit documents, please contact us directly
Education and Training Taxonomy
Best characterization of extent of health psychology training in the program: If more than one, select highest level achieved. See attached Clinical Health Psychology Taxonomy: See full taxonomy by clicking on image below or at: http://www.cchptp.org/ or http://cospp.org/specialties/clinical-health-psychology
Highest Level of Health Psychology Training in Program
*
Major Area of Study
Emphasis
Experience
Exposure
Required File Upload
*
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Additional Information Required: Please provide a letter of support from the chairperson/ head of your Department/Division/Section attesting to the fact that the clinical health training program is an integral part of the Department/Division/Section and offers support for program membership in CCHPTP.
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What's Next
After board review and approval of the membership, and invoice will be sent to the email listed on this application for dues payment and payment instructions.
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