FORMS

The Louisiana Behavior Analyst Board offers assistance to Behavior Analysts in obtaining licensure. Below are downloadable versions of necessary forms and applications.  PLEASE NOTE:  In order to apply for licensure in Louisiana, you must first be certified by the Behavior Analyst Certification Board.  Please visit bacb.com for more information on national certification.

HELPFUL NOTE:  In some cases a form in PDF is not fillable online.  Click print, then preview in PDF and a copy will be created to your computer which is fillable in some instances.

PLEASE READ ALL APPLICATIONS CAREFULLY - LBAB DOES NOT ACCEPT PERSONAL CHECKS, BUSINESS CHECKS, OR CASH

LBA/SCABA Application Portfolio

The Louisiana Behavior Analyst Board may use the criminal
convictions of applicants as a basis for denial of an application
for licensure. The Board is required to consider the following
factors in deciding whether to grant a license to an applicant
with one or more criminal convictions:
(1) the nature and seriousness of the offense(s);
(2) the nature of the specific duties and responsibilities for which the license is required;
(3) the amount of time that has passed since the conviction(s);
(4) facts relevant to the circumstances of the offense(s), including any
aggravating or mitigating circumstances or social conditions
surrounding the commission of the offense(s); and
(5) evidence of rehabilitation or treatment undertaken by the person since the conviction(s).

NOTE:  See website home page  to view Act 590 report for year end licensing report.  Average timeline from receipt of completed application to issuance of license averages 3 – 5 weeks.

Contact Person:  Krysta Babin/Executive Administrator 225-295-8413.

Application – Frequently Asked Questions

 

LBA/SCaBA Application Updated (2023)

 

License/Certification Verification Form

UPDATED Application for Line Technichian Registration and Proof of Supervision Form (2023)

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Proof of Supervision SCaBA only

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CRIMINAL BACKGROUND CHECK PACKET AND INSTRUCTIONS - DO NOT USE THESE FORMS UNLESS AN APPLICATION IS BEING SUBMITTED

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Renewals to be submitted by December 31, 2022.

LBAB 2022 CEU Reporting Form

Breakdown of hours for the 2022 Reporting Period

Hours must be earned from January 1, 2021 – December 31, 2022

Licensed Behavior Analysts

  • Licenses issued in 2020 or before:  32 credits, 4 in ethics
  • Licenses issued in 2021:  16 credits, 2 in ethics
  • Licenses issued in 2022:  0 credits

State Certified Assistant Behavior Analysts

  • Certificates issued in 2020 or before: 20 credits,4 in ethics
  • Certificates issued in 2021:  10 credits, 2 in ethics
  • Certificates issued in 2022:  0 credits

2022.LBA.RENEWAL.FORM

2022.SCABA.RENEWAL.FORM

2022.RLT.RENEWAL.FORM 

Supervisory Discontinuation Form

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Supervisory Change Form within Same Company

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