Accusation Form - State of NV Board of Examiners for Social Workers

This form must accompany all accusations.

Person Filing Accusation (Complainant)

This information is required in order to process your accusation. Forms with incomplete or omitted information risk not being processed.


Name of Person Filing Accusation (You may not file an accusation anonymously)
Company/Agency	Your Contact Phone Number	Your Email
Your Address
City	State	ZIP Code

Social Worker this Accusation is filed Against (Respondent)

Please use one form for each social worker you are filing an accusation against.
If the individual you are trying to file an accusation against is not in the dropdown list of licensed social workers below, than they are not a licensed social worker and you cannot file an accusation with this board. You may go to the website https://services.socwork.nv.gov/verify/index.asp to verify licensure in Nevada. If the social worker is not in the list, please contact the board office at 775-688-2555 before proceeding.


Social Worker's Name
Company/Agency		Social Worker's Contact Phone Number
Agency Address
City	State	ZIP Code