Louisiana Family Recovery Corps
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Service Providers

To register to be included in the Recovery Corps Provider Directory, please fill out the form below.

For questions please contact:
Dr. Jackie Mims
(225) 381-3915
jmims@recoverycorps.org

We appreciate your valuable contribution and cooperation in helping to restore the lives and communities of displaced Louisianians throughout the state.

Thank You.

PLEASE NOTE: Groups interested in conducting a one-day or weekend activity or project on-site with displaced families MUST complete an official background check on each individual in the group.

Pursuant to Code 15:587 of the Louisiana Revised Statutes, state law requires background checks on anyone wising to volunteer or work with children.

Go to www.lsp.org/special.html and click on Background Check Forms to print out the forms that must be completed and submitted. The Louisiana State Police need the Authorization Form and the CPA Disclosure Form completed and returned to the Louisiana State Police (the address, instructions, and list of other items that must be sent in are included on the form).

Do not send to the Recovery Corps - this background check will be for your records.

Organization Name:
Organization Address:
 
City:
State:
Zip:
Services (Please briefly describe the services you provide):
Date Available:
Contact First Name:
Contact Last Name:
Office Phone:
Cell Phone:
Email:
What is your website address?
Where in state can you provide services?
Is your organization a non-profit? Yes No

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339 Florida Street, Suite 200, Baton Rouge, LA 70801   ///   (504) 301-3420   ///   info@recoverycorps.org   ///   Staff / Partner Login