Form Instructions

  1. Please complete the forms below
  2. Please save and email to: [email protected]  or print and fax to: (318) 352-9818
  3. If you have any questions or problems filling out the forms you may reach us at: (318) 352-9595

New Patient Paperwork

OB Patient Paperwork

Medical Releases

Make a Payment Options

  • Mail checks to 627 Bienville Circle, Natchitoches, LA 71457. Make checks payable to Natchitoches Women’s Care. Please include payment stubs and write your account number on the memo line of the check.
  • Pay by credit card using your Visa, Mastercard, American Express or Discover card by phone: 318-352-9595 .
  • 20% Discount from CPL

Useful Contacts:

Patient Support Group

Central Louisiana Breastfeeding Coalition, Inc.                    

318-451-1929 or 318-561-7805

If you are interested in enrolling in one of our programs, OR learning about our Coalition, please fill out the information below and leave with the receptionist or nurse.

To be eligible for CLBC programs, applicants must reside in Avoyelles, Natchitoches, or Rapides parish. Call for more information.

My Patient Portal

Patient Portal