Forms - 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.
Start your electronic application(s) at the link provided at the bottom of the page.
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 2025-2026
302-RNS ~ Application for Reinstatement of DME Permit (use for expired or closed credentials)
304 ~ Application for Relocation of DME Permit
Change of Owner's Managing Officer
065 ~ Notice of Change of Owner's Managing Officer (OMO)