1. Update Request Contact Information

Requester Information (from person completing this form)

Update Requested By (if different that the person submitting this form)

Who is the contact that will be approving this update on the website?

Is there a specific date that the website update must be live by? If yes, please provide date.

Please give details as to what needs to be updated. Remember to include all information needed to complete the update, for example text, links and pictures to be modified. Include the current content and specific directions. If you are requesting a change to the text, please include the original text and the replacement copy below.

If there is an accompanying file that needs to be uploaded to the website, please email it to webdevelopment@ochsner.org.

3. Additional Assets to add to Web Page

Would you like to add an image(s) to your website update? If yes, upload your images below.

Would you like to link to a video? If yes, please provide link to video on the Ochsner YouTube page or instructions on how to access the video file.

Would you like to link to a blog post on the Ochsner To Your Health blog (blog.ochsner.org)? If yes, please provide the link to the blog article.

Are there Ochsner clinical trials that should be linked to from this page? If yes, please provide the details.

This form does not encrypt your message and it is not an appropriate means of communicating confidential information. Do not use this form to send personal information, such as account numbers, insurance information or social security numbers. We do not provide medical advice through this form.