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New Full CAPDA Member Sign-up

CONTACT INFORMATION (for the CAPDA directory and website)













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MEMBERSHIP INFORMATION (for internal records only)


Please provide provincial/state registration/license information:


Date of Registration



If you have a doctoral degree from an accredited educational program acceptable to your provincial or state regulatory body for registration for the practice of psychology, please enter below


Year of Graduation


If you have at least five years of post-doctoral experience relevant to psychological disability assessment, please describe this experience below, noting the services delivered, settings, special training, client groups, supervision, etc.
(Note: applicants with less than five years of relevant post-doctoral experience and training in psychological disability assessment should instead apply to become an Early Disability Assessor Member).

In your judgment, are you a member in good standing of the profession?
 Y    N

If you have less than five years of relevant post-doctoral experience and training in psychology relevant to psychological disability assessment, are you pursuing further training, education experience, and practice in psychological disability assessment (e.g., this might include attending conferences and workshops, conducting disability assessment under supervision, self-directed learning/readings, peer consultation)? If yes, please briefly describe your plans for further training, education and experience


If you have documented (so that you can attest to having completed) at least 50 continuing education hours in disability assessment over the past year, please specify the number of hours per week you devote to disability assessment and/or rehabilitation management/treatment.
Note: peer consultation and supervisory hours (both as supervisor or supervisee), self-directed reading and research, formal workshops all count as continuing education hours


Submit two (2) letters of reference from registered psychologists.


Your documents need to be a PDF or Word file. File size limit is 4 MB


Your documents need to be a PDF or Word file. File size limit is 4 MB

- This is mandatory in order for your application to be considered!
Your documents need to be a PDF or Word file. File size limit is 4 MB

- with examinee and other identifying information removed. This is mandatory in order for your application to be considered!
Your documents need to be a PDF or Word file. File size limit is 4 MB

Applicants for Member (but not for Candidate) are required to provide a sample disability assessment. Please consider the following in doing so.

The CAPDA website has links to sites that discuss standards for disability assessment reports.

Practice standards are addressed here.

The Practice Handbook for MVA Work, 2010, contains a lot of helpful information re reports (esp. pages 9-19).

Also, OPA Auto Guidelines for Assessment and Treatment in Auto Insurance Claims (esp. 45-65), 2010.

Also, APA Specialty Guidelines for Forensic Psychology, especially section 10, Assessment.

The Joint OPA/CAPDA Guidelines for Best Practices in Psychological Insurer Examinations, Aug 30, 2016.

In addition to the above formal references, please consider the following.

  1. The report is a disability assessment as opposed to a strictly diagnostic/treatment report.
  2. Identifying information is redacted thoroughly.
  3. Typographical errors are minimal.
  4. Standard elements of a comprehensive report are present such as:
    • informed consent and reason for referral
    • referral source (where appropriate)
    • bio or description of qualifications or the author
    • file review
    • social/personal history
    • education/employment history
    • medical/psychiatric history
    • collateral input if relevant
    • behavioural observations
    • complete list of tests used
    • description of psychometric test results
    • clinical formulation/diagnostic impression
    • presence, nature, and severity of impairment/disability and impact on functioning
    • relation of injuries, diagnoses and impression to the statement of claim and comment on causality; recommendations if relevant.
  5. Presence and appropriate use of symptom and/or performance validity measures.
  6. Cultural, language, and other matters of diversity are addressed, if relevant.
  7. The tone is neutral, and the report is objective.
  8. Demonstration of good scientific reasoning ability.
    • Citation of published findings, research or scientific documents used in the body of the report.
    • Appropriate synthesis of all data, and conclusions follow logically from multiple sources of information such as file review, interview, behavioural observations, psychometric testing, and collateral input.
  9. Conclusions and recommendations are limited to the assessor’s scope of practice in psychology/neuropsychology.


PRACTICE INFORMATION (for the CAPDA directory and website)


Locations Where Clinician is Licensed to Practice
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 MB  
 NB  
 NL  
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 ON  
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 SK  
 YT  

Assessment Services

If you conduct disability assessments, what percentage of your work are disability assessments?

Check the types of disability assessments conducted:
 Clinical  
 Health  
 Neuropsychology  
 Rehabilitation  
 Vocational  
 Other  
If you select 'Other', please describe:

Check the age groups for which this is provided:
 Adolescents  
 Adults  
 Children  
 Elderly  
 Infants  
 Other  
If you select 'Other', please describe:

Check referral sources for disability assessments:
 Assessment Agencies  
 Insurers  
 Lawyers  
 Physicians  
 Rehab Personnel  
 Self  
 Other  
If you select 'Other', please describe:

Therapy Services

Types of intervention:
 Behavioural  
 Biofeedback  
 Cognitive  
 Cognitive Retraining  
 Family  
 Hypnosis  
 Insight Oriented  
 Marital  
 Rehabilitation Counselling  
 Other  
If you select 'Other', please describe:

Types of conditions:
 Adjustment Disorders  
 Anger  
 Anxiety Disorders  
 Behavioural Disorders  
 Chronic Pain  
 Cognitive Impairment  
 Mood Disorders  
 Post Traumatic Stress Disorder  
 Other  
If you select 'Other', please describe:

Check the age groups for which this is provided:
 Adolescents  
 Adults  
 Children  
 Elderly  
 Infants  
 Other  
If you select 'Other', please describe:

Check referral sources for rehabilitation-oriented therapy:
 Insurers  
 Lawyers  
 Physicians  
 Rehab Personnel  
 Self  
 Other  
If you select 'Other', please describe:

Languages in which you provide services (other than English)

 Cantonese  
 French  
 Italian  
 Spanish  
Other, please describe:

Authorization

Do you want to join the general membership ListServ?
 Y    N

Show my email on the public Member Directory
 Y    N

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