Forms

Woman & Newborn Services Registration Form

 

To register, please fill out the EJGH Woman and Newborn Registration form, which can be filled in electronically. When you’re done, print it out along with:

  1. A copy of your I.D.
  2. A copy of your insurance card (front and back)

Scan all documents and email to: EJ_Womanandchild@lcmchealth.org or Fax to: (504) 456-5485; if you would prefer, we will be happy to make these copies for you. Feel free to visit our Woman & Child area located on the 4th floor of the hospital.