Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary


Aging & Adult Services Request for Services

To request services through the DHH Office of Aging and Adult Services, you may call the Louisiana Options in Long-Term Care Hotline at 1-877-456-1146. If you are requesting services on behalf of someone else, please have that person's name, physical/home address and Medicaid number (if applicable) readily available when calling.  You may also submit a request for services using the form below, and a staff member will contact you for assistance and further information.
I am requesting information about :

(Please select the category that best matches the type of services you are seeking. )

(First Name)

(Last Name)
Zip Code:
Phone Number (with area code):
E-mail Address:
I am requesting services on behalf of :
Someone else
(If you are requesting on behalf of someone else, please have that person's name, address and Medicaid number, if applicable, available when speaking with staff.)
Additional Information:

(Please provide any additional details on the types of services you are requesting so staff may better assist you. )