Forms

On this page you will find forms and information required for obtaining and maintaining your psychology license, as well as other public forms.

LICENSED PSYCHOLOGIST AND PROVISIONAL LICENSED PSYCHOLOGIST

RECIPROCITY APPLICATION

REQUIRED: PUBLIC DISPLAY OF BOARD ADDRESS

Board Address Sign

COMPLAINT FORMS

Request for Investigation
Consent Release

LICENSEE RENEWAL FORMS

CONTINUING PROFESSIONAL DEVELOPMENT (CPD) VERIFICATION FORM(To be completed for and retained for your records when claiming credit for peer consultation, continuous practice outcome measure, professional activities, and self-directed learning activities.)

2018 Renewal Application

2018 Psychologist Continuing Professional Development Report    

2018 LSSP Continuing Professional Development Report

2018 Fee Reduction Application

2018 Continuing Education Extension Application

CPD Emergency Rule- Effective 6.1.16

Memorandum: CPD Reporting Requirements for Licensed Psychologists

Memorandum: CPD Reporting Requirements for Former Emeritus/Even Numbered Licenses

NOTICE: In compliance with Act 655 of the 2018 Regular Session, the LSBEP hereby gives notice to its licensees and applicants of their opportunity to file a complaint about board actions and board procedures. You may submit such complaints to one or more of the following organizations:
•Louisiana State Board of Examiners of Psychologists:Submit in writing to: LSBEP, 8706 Jefferson Highway, Suite B, Baton Rouge, LA  70809; admin.lsbep@la.gov; (225)925-6511
•Committee on House & Governmental Affairs, La. House of Representatives:Submit toH&GA@legis.la.gov or Committee on House & Governmental Affairs, La. House of Representatives, PO Box 44486, Baton Rouge, LA 70804; (225) 342-2403
•Committee on Senate & Governmental Affairs; La Senate:Submit tos&g@legis.la.gov or Committee on Senate & Governmental Affairs; La Senate PO Box 94183, Baton Rouge, LA 70804; (225)342-9845