Share Your Story

Thank you for taking the time to share your story. From our patients to our employees, we can't wait to hear more about your experiences at Ochsner LSU Health.In the form below, please be sure to give us as many details as you can about your overall experience and story.

First Name

Last Name

Phone

Email

Date of Birth

gender Male Female Prefer not to say

I certify that I am 18 years of age or older I certify that I am 18 years of age or older

I authorize the Marketing and Communications Department at Ochsner Health to contact me regarding the use of my patient or employee story I authorize the Marketing and Communications Department at Ochsner Health to contact me regarding the use of my patient or employee story

By checking this box, I authorize Ochsner Health to utilize my story and relevant portions of my medical record. By checking this box, I authorize Ochsner Health to utilize my story and relevant portions of my medical record.

Tell us about your story of care at Ochsner LSU Health

Stories are reviewed by our team for consideration to be shared in short articles and/or videos, so feel free to include details about who you are - your hobbies, passions, and/or community involvement activities.

Your Story

Treating Physician, Nurse or Other Staff Members

Service/ Department Visited Service/ Department Visited Cancer Care Heart and Vascular/ Cardiology Neurosurgery/ Neurology Pediatrics Primary Care Women's Services (OB/GYN) Orthopedics Digestive Disorders/ Gastroenterology Virtual Visits Other (please specify)

If other, please specify

Ochsner LSU Health Location(s) - Please specify

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Electronic Signature

Date

Contact Information for Person Submitting Form (if other than patient)

First Name

Last Name

Email

Phone

I am the parent or authorized guardian of the aforementioned patient. I am the parent or authorized guardian of the aforementioned patient.

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This form does not encrypt your message and it is not an appropriate means of communicating confidential information. Do not use this form to send personal information, such as account numbers, insurance information or social security numbers. We do not provide medical advice through this form.