​​Catahoula Parish


 Patient Forms

In order to make your records available to other doctors, we ask that you complete the Medical Release Form below. You may fax it to our office or drop it by in person. Please allow up to 3 business days for your request to be processed.

Ferriday Family Health Center

Medical Release Records from CPHD2

Medical Center Family Dentistry
710 Chisum St.
Sicily Island, La 71368
(318) 389-9941

Ferriday Family Health Center
100 Serio Blvd.
Ferriday, La 71334
(318) 757-6969

Wisner Medical Clinic
126 Watson St.
Wisner, La 71378
(318) 724-7008

​Thank you for choosing CPHD2 for your healthcare. We strive to make your experience with us as convenient and efficient as possible. The downloadable forms below can be printed and faxed to us or brought with you to your visit. If you have any questions, please give us a call.

New patient? Please complete the form below and bring it with you to your first appointment. We look forward to serving you!

If you need your medical records released to yourself please download the form below and fax it to us so that we may process your request.

Patient Privacy Practices

Sicily Island Medical Center

Medical Center Family Dentistry

Jonesville Medical Clinic

Wisner Medical Clinic

Copyright ©  2106 Catahoula Parish Hospital District #2

Jonesville Medical Clinic
900 Foster St.
Jonesville, La 71343
(318) 339-7265

Medical History


Fax Numbers:


 Hospital District #2  

Harrisonburg Family Health 


Patient Information​



Sicily Island Medical Center
307 Chisum St.
Sicily Island, La 71368
(318) 389-5272​​​

Providing your medical history allows us to serve you better. Please answer each item as carefully and accurately as possible to ensure a medical meaningful document

Medical Release Records to Self

CPHD2 is dedicated to protecting your privacy, including the protected health information about you that we generate and maintain.