Louisiana Syndromic Surveillance - Registration of Intent for Hospital Emergency Departments and Urgent Cares

Please use this form to register your intent to participate in Syndromic Surveillance if you represent a hospital with an emergency department or an urgent care facility. Other providers are not eligible for syndromic surveillance in Louisiana at this time and can claim an exclusion from the meaningful use objective.

If you represent a hospital system with more than one eligible emergency department or urgent care, please submit a registration form for each facility.

Upon completion, you will receive an email acknowledgment of your registration within 5 business days. Please contact Jenna Iberg Johnson with any questions: jenna.ibergjohnson@la.gov or 504-568-8312.

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