If a form is being sent after 5:00 p.m. on a business day (Monday - Friday) or on a state holiday that falls on a business day, the form will be stamped as received on the next business day. 

 

Motion for Continuance

Submit this form if you discover you have a conflict with your scheduled hearing or conference date. This motion will request that the administrative law judge assigned to preside over your matter reschedule your hearing date. You must include your docket number and reason you are requesting to reschedule the hearing.

 

Withdrawal of Hearing Request

Use this form only if you want to withdraw your hearing request and waive your right to an adjudicatory hearing.

 

Records Request

To request records, including transcripts or audio recordings, please submit a Records Request Form or email PRRprocessing@adminlaw.state.la.us.  The Division of Administrative Law's Custodian of Records is Tina Perkins, Administrative Hearings Clerk. 

 

Subpoena Request

Use this form to request that DAL issue a subpoena commanding a person to appear as a witness to testify, or to require a person to produce documents or videos (subpoena duces tecum).  You must pay the appropriate witness fee before a subpoena will be issued and you are responsible for serving it.  To read instructions for the deposit of witness fees and how to serve a subpoena, click here.   

 

Motion to Enroll as Counsel of Record

Use this form to enroll as counsel of record. 

 

Medicaid Recipient/Applicant Appeal Request

This form is only applicable if you are a Medicaid recipient/applicant who wants to appeal a decision made on a Medicaid case or application.  To request a recipient/applicant fair hearing, please submit a Recipient/Applicant Appeal Request Form online or mail a request to:  Division of Administrative Law - HH Section, P.O. Box 4189, Baton Rouge, LA 70821.  The request may also be faxed to (225) 219-9823.

 

Response to Conditional Order of Dismissal

Complete this form if you missed your hearing and received a Conditional Order of Dismissal and would like to have another hearing scheduled.

 

Medicaid Provider Appeal Request

This form is only applicable if you are a Medicaid provider (not Medicaid recipients/applicants) who wants to request an appeal. You must upload a copy of the decision letter from which you are appealing with your request.  To request a provider appeal, please submit a Provider Appeal Request Form online or mail a request to:  Division of Administrative Law - HH Section, P.O. Box 4189, Baton Rouge, LA 70821.  The request may also be faxed to (225) 219-9823.

 

Medicaid Withdrawal of Appeal Request

Complete this form if you want to withdraw your Medicaid appeal request.

 

Deptartment of Children and Family Services Appeal Request for Investigative Finding

Complete this form if you want to appeal a finding by DCFS regarding a child abuse and/or neglect investigation. You must upload a copy of the notice letter received from DCFS informing you of the finding and your appeal rights.  If you do not attach the notice letter, your appeal will be rejected as incomplete If you are unable to provide the required information for electronic submission, please print and submit DCFS Form B

 

DPS - Certification of Evidence Form

Use this form to certify that recordings you intend to have admitted into evidence at a DPS hearing are unedited and complete copies of the entire recording obtained from the arresting agency in response to the inspect and copy subpoena issued by DAL.