A healthier, more productive Louisiana
Application
LHCA Membership Application

 

Company Name::
Mailing Address:
City State Zip:
Primary Contact (to receive information):
Title:
Phone:
Email:
Number of Benefits Eligible LA Employees:
Brief Description of Company (Employer, Insurer, Pharmaceutical, Consutlant, Health Care Provider, Association):
HR/Benefits Manager (if different than Primary Contact):
Owner/CEO:
Name of Lobbyist: