BCBA Application for

Voluntary Inactive Status

Overview
BCBAs who are granted voluntary inactive status may remain inactive for up to 4 years. Inactive BCBAs are not
permitted to practice, bill, or represent themselves as an BCBA and not be listed on the Certificant Registry. In
addition, inactive BCBAs will not be required to submit recertification applications (including fees) while inactive.

BCBAs who wish to request this status will need to (a) be in their recertification window and (b) have completed
continuing education for their recertification cycle (prorated to the month). For example, if a BCBA is 12 months
into their current certification cycle, they would need to complete 16 CEUs by the time this application is submitted.

Returning from Voluntary Inactive: When an BCBA wishes to reinstate their certification, the BCBA will need to:
1) Submit a Request to Return from Voluntary Inactive Status (including fees) to the BACB and
2) If they have been inactive for more than two years, complete 8 hours of CEUs in the 12-month period prior to
reactivation.
After their certification becomes reactivated, their recertification cycle will restart where it was paused. For
example, if the BCBA went inactive 8 months into their cycle, they will have 14 months until they need to
recertify again (and meet the recertification requirements).

If a BCBA fails to return from inactive status, their BCBA certification will expire and they will be required to
requalify under the then-current requirements to become certified again.

Instructions
BCBAs who wish to request inactive status will need to:
1) Enter CEUs (pro-rated to the month) in their BACB Account.
2) Complete this application and submit it through the Contact Us Form prior to their certification expiration date.
3) Pay a $50 non-refundable processing fee by either:
a) Sending a check to: Behavior Analyst Certification Board 7950 Shaffer Parkway Littleton, CO 80127 USA
or
b) Paying via credit card. If choosing this payment option, BACB staff will send the information on how to
pay once the application has been received.
4) Allow at least two weeks for processing.
If approved, their voluntary inactive status will start the day the application is approved.

A. BCBA Information
BCBA’s Legal Name:________________________________________________________________________

BCBA Certification # (located in your BACB Account): _______________

Updated 11/2018, Copyright © 2018, BACB® | All rights reserved. Behavior Analyst Certification Board | BCBA Application for Voluntary Inactive Status | 1
B. Ability to Practice
I (BCBA) understand that while I am on voluntary inactive status:

 Agree I may not practice as a BCBA. Practicing as a BCBA is defined as engaging in any tasks identified in
the BCBA/BCaBA Task List.

 Agree I may not identify myself as a BCBA

 Agree I may not bill for services as a BCBA

 Agree I will not be listed on the BACB’s Certificant Registry.

C. Supervision
While I (BCBA) am on voluntary inactive status:

 Agree I may not serve as a RBT Requirements Coordinator or RBT Supervisor for RBTs.

 Agree I may not provide ongoing supervision to RBTs or BCaBAs.

 Agree I may not provide supervision to trainees who are pursuing the BCaBA or BCBA credential.

D. Required Reporting
I (BCBA) understand that while I am on voluntary inactive status:

 Agree That I am required to report to the BACB any physical conditions, mental conditions, or substance
addictions that could impair my ability to competently provide behavior-analytic services and/or
jeopardize public health and safety.

 Agree That I am required to report to the BACB any disciplinary investigations or actions by a
professional or regulatory body.

 Agree That I am required to report to the BACB any public health or safety-related investigations or actions.

E. Attestation
By signing, I (BCBA) acknowledge and affirm that:

 Agree I have carefully read and understand the BACB rules and requirements, to include the
Terms and Conditions.

 Agree I agree to abide by the BACB’s rules and requirements, including the Terms and Conditions.

 Agree The information I have provided in this application is true and correct to the best of my knowledge.

If you need to report any information or noncompliance with BACB requirements, you may do so via the submit
legal documentation form on the BACB website. Please note, this may delay processing of your application.

BCBA’S PRINTED NAME: _____________________________________________________________________

BCBA’s SIGNATURE: _______________________________________________________ DATE:____________

Updated 11/2018, Copyright © 2018, BACB® | All rights reserved. Behavior Analyst Certification Board | BCBA Application for Voluntary Inactive Status | 2