Rural Health Clinic Relocations

The information and forms in this packet are designed to assist providers in submitting the information to relocate a Rural Health Clinic.  Please keep in mind that each license is for the SPECIFIC geographical address that is printed on the license.  If you relocate the license is no longer valid.  Failure to get approval from Health Standards before relocating the Rural Health Clinic will result in the Rural Health Clinic no longer having a license to provider services.  Please mail this packet to the Department of Health & Hospitals, Health Standards Section, P.O. Box 3767, Baton Rouge, LA 70821.  Any fees associated with the application should be sent to LDH-Licensing, P.O. 62949, New Orleans, LA 70162-2949. 

Please choose the type of Rural Health Clinic that you are relocating: