mandates that all licensees must notify the Board of a "qualified person" (or "QP") who will intercede for client welfare, maintain and access client records to ensure confidentiality, and make necessary referrals in the case of death or incapacity of the licensee. The qualified person must be an active or semi-active Oregon licensed psychologist
- Note: Some computer settings will block this fillable form. If this happens, please contact your IT provider, or try our non-fillable form.
Q & A
Q: What if my employer maintains the records?
A: If you do not own any client records (i.e. your place of work owns them), you may simply put on your form the name of the organization along with the name and contact information for the organization's records custodian so that we can refer clients if ever necessary. No signature or license number is required on the form in this case.
Q: What if my QP is no longer available to serve, retires, or places their license on inactive status?
A: Licensees are required by law to keep the Board updated with the name of their qualified person. Please update the Board with any change in your qualified person simply by sending in a new completed form. You will need a new QP if yours is no longer an active or semi-active psychologist, you have chosen someone else for this role, or if you begin work at another organization or enter private practice.
Q: What if I don't have any client records?
A: Some licensees will not have client records because they are newly licensed and have not yet began practicing, have been on inactive status for some time and no longer have client records (past the 7 year retention), or have not worked in an area that involves client records. You will need to notify the Board in writing (please email firstname.lastname@example.org
or send via mail to OBOP, 3218 Pringle Road SE, Ste. 130, Salem, OR 97302) that you do not maintain records for any Oregon clients along with a brief explanation as to the reason. You will need to designate a QP if your situation changes such that you maintain client records.
Q: Can my QP be someone who is not an active or semi-active Oregon licensed psychologist?
A: No. The law is specific as to who may be designated. Forms that do not meet this criteria will be rejected and returned.
Oregon law also requires that psychologists and psychologist associates make necessary arrangements for maintenance of and access to client records to ensure confidentiality in case of death or incapacity of the licensee. Once a qualified person has been identified to the Board, the next step is to make arrangements to provide all the necessary information to your qualified person.
The following resources are provided to help with this process: