Complaint Form Against Louisiana Psychologists Licensees

Submit a Complaint

The Louisiana State Board of Examiners of Psychologists (“Board”) is created “to safeguard life, health, property, and the public welfare of this state, and in order to protect the people of this state against unauthorized, unqualified, and improper application of psychology.” The Board takes seriously this obligation and conducts investigations and take such actions necessary to carry out this charge in accordance with LA R.S. 37:2351- 2378 et al.; the Louisiana Administrative Code Title 46, Part LXIII. Psychologists (Psychology Laws); and the Louisiana Administrative Procedures Act (LAPA), LA R.S. 49:950 et seq.

Please submit your complaint securely by completing the online complaint form below and uploading any supporting documentation.

Please be advised that the Board is not permitted or authorized to:

• to provide psychological opinions or advice;
• provide legal representation or opinions to complainants;
• impose civil remedies, such as monetary damages or restitution to compensate complainants or to resolve fee disputes, which are civil matters. If you are seeking damages or restitution, please consult a private attorney for guidance

• or impose criminal penalties, such as jail sentences or criminal probation.
  If the Board determines after investigation that disciplinary proceedings should be initiated against the professional’s license or registration, please be advised of the following:

• The role of the Board is to determine what is necessary for public protection and cannot advocate on behalf of an individual complainant.

• The parties in any administrative law proceeding are the Board and the licensee/applicant for licensure. Complainants are not considered a party to an administrative proceeding.

• You may be asked to provide further information throughout the investigation or called as a witness in future proceedings, in which case we look forward to your cooperation. In some cases, the Board may be able to proceed without your testimony or additional information. Testimonial privileges, exceptions, and waiver with respect to communications between psychologist or licensed specialist in school psychology and patient are governed by the Louisiana Code of Evidence, psychology laws, and the LAPA.

• Investigations are confidential and are not public records. This means that the Board cannot provide you with a copy of any investigation.
  Note: Filing a complaint with the Board does not preclude you from filing a separate civil or legal action. If you believe your allegations may constitute a criminal violation, please contact your local law enforcement agency regarding the procedure for filing a criminal complaint.

Required fields are denoted by this symbol:

Complainant Information

NOTICE: LAC:46.LXIII.§1503.D.1. provides that "[e]xcept under unusual circumstances, the board will take no action on anonymous complaints." The Board may investigate anonymous complaints if independently verifiable information is provided in the Request for Investigation. Such independently verifiable information includes, but is not limited to, dates of treatment, insurance company/third party payor, names and contact information of witnesses to the alleged action or inaction, case names and numbers, parish/date of arrest, treatment record(s), and/or evaluation report(s).

Is this an anonymous complaint? I wish to remain anonymous. I am... Patient, Client or other concerned citizen Psychologist Specialist in School Psychology Board (option for Board use only) First Name Last Name Email Phone number Use the following format: 999-999-9999. Format must be 999-999-9999. This field is required. Address Line 1 Address Line 2 City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State ZIP Code Format must be 99999 or 99999-9999. Name of Patient (if different) Patient's Date of Birth Relationship of Person Initiating Request to the Patient

Person Being Investigated

First Name Last Name Phone number Use the following format: 999-999-9999. Format must be 999-999-9999. This field is required. Address Line 1 Address Line 2 City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State ZIP Code Format must be 99999 or 99999-9999. License Number Psychologist Specialist in School Psychology Not Licensed/Other License Type

Details

General Nature of Investigation Request Competence Dual Relationships Sexual Misconduct Substance Abuse Failure to release patient records Other Other You may choose more than one. Details of Incident(s) Include specific details such as, names, dates, particulars about the alleged violation(s), or other pertinent facts. By my signature below, I affirm that the information provided is true, and correct to the best of my knowledge. I understand by filing this complaint, I do authorize the Louisiana State Board of Examiners of Psychologists to investigate and resolve this matter in accordance with the Board's rules and regulations.

Signature Date Reset Submit