Download Forms

Online Forms

Please print and fill out the following forms to bring along on your first office visit. Also, remember to bring a picture ID, proof of income, and insurance card(s).

Trinity Community Health Centers of Louisiana Documents

Print and complete the following:

  • Name

  • Address

  • Date of Birth

  • Social Security #

  • Sign and Date

Once complete return the form to your local health center.

Trinity Community Health Centers of Louisiana Forms

To make an appointment, please contact the location of your choice.


Trinity Community Health Centers of Louisiana Dental Forms

Locations: Bienville - Grant - Lincoln - Winn

To make an appointment, please contact any of the locations listed above.

Behavioral Health Forms