Online Registration

Ronald McDonald House of South Louisiana

* Patient Name ( First and Last )

* Patient Date of Birth (MM/DD/YYYY)

* Unit

Who will be staying at the House with you?

Caregivers and immediate family members are eligible to stay. The maximum number our rooms can accommodate is 5 guests.

* Primary Guardian

U.S. / Canadian Postal Code lookup

* Country

* Address

City/Villa/Town

County/District

Zip

* Primary Phone Number

Additional Guests / Family Members: * * * *

Add Another Guest

* Requested Check in Date

* Anticipated Check Out Date

* Has any family member or guest who are planning to stay been exposed to any infectious disease such as mumps, measles, chicken pox, or tuberculosis?

Does everyone 18 and older, who are planning to stay at RMHC-SLA, have a valid ID showing their current address? If not, proof of residency will be required.

Does anyone who will be staying with us have any dietary restrictions? If yes, please provide details.