Rural Health Clinic DBA (Doing Business As) Name Change Packet

The information and forms in this packet are designed to assist providers in completing information to change the "DBA" name of the Rural Health Clinic.  Please DON'T use this packet if the corporate/legal entity name changes.  Please send this packet to the Department of Health and Hospitals, Health Standards Section, P. O. Box 3767, Baton Rouge, LA 70821.  Please send all payments associated with this packet to LDH-Licensing, P. O. Box 62949, New Orleans, LA 70162-2949.

If the name change occurs in an RHC that is licensed as an offsite campus of a hospital you will also need to submit a Hospital DBA Name Change Packet to the Hospital Program Manager assigned to your hospital.