Alert
Alert

The Board of Pharmacy will NOT contact you by telephone and demand payment of funds for any reason. Please be aware of scammers identifying as board staff and using phone numbers issued to the board.

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Forms & Applications

Durable Medical Equipment (DME) Providers 

 

New Applications 

The Application for New Durable Medical Equipment Permit, for both resident and nonresident, is available by electronic format (online). 

To preview the applications and review the application checklist visit the Application Process Transparency page.  

To start your electronic application(s), click here.

Should you require a paper application, please submit a written request for such to the board office at 3388 Brentwood Drive, Baton Rouge, La 70809. Your request should include the full address which you would like the paper application mailed.

71 ~ Facility Ownership Disclosure Form

 

Renewal, Reinstatement, and Relocation Applications

302 ~ Application for Renewal of DME Permit for Year 2024-2025 (available July 1 - August 31)

302-RNS ~ Application for Reinstatement of DME Permit

304 ~ Application for Relocation of DME Permit

 

Change of Owner's Managing Officer

065 ~ Notice of Change of Owner's Managing Officer (OMO)