Interested in your school being a part of MedStart?
Schools for the 2026-2027 academic year have been confirmed. Complete the form below to be considered for future program years. CLAHEC staff will be in touch with you to discuss.
School Name
Parish your school is located in:
*
Please Select
Allen
Avoyelles
Catahoula
Grant
LaSalle
Natchitoches
Rapides
Vernon
Winn
Does your school offer access to the following students (select all that apply):
*
7th grade
8th grade
Name of Individual completing form?
*
First Name
Last Name
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
School Main Point of Contact
This is the person that would be responsible for scheduling dates, confirming availability, and coordinating with CLAHEC for student forms, shirts, equipment, and meeting space.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
Should be Empty: