Save time! Print and complete the following forms for your health center visit. Please use black ink.(PDF)
- Welcome to Planned Parenthood Information
- Authorization Form for Release of Health Information (Needed only if you need your records transferred to or from another location.)
- Gardasil Vaccine Patient Assistance Application - Some women may qualify for financial assistance for GARDASIL, the injection that helps protect women against diseases caused by HPV - the Human Papillomavirus. Complete this application and bring it to a Planned Parenthood health center to see if you qualify.
Our health services are confidential. For more information you may read the Health Information Privacy Practices.(PDF)
Click here to see the Louisiana Notice of Required Reporting
