Patient Registration
You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Online Referral Form
Referring doctors may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.
We truly understand the importance of communication to achieve the best results for our mutual patients. If you have any questions or concerns please do not hesitate to contact our office at Lake Charles Office Phone Number 337-477-6124.
Other Forms
Only if instructed by our office, please download and sign our consent form ahead of time. Please make sure to bring it with you or fax it back to our office at 337-477-6685. Note: (Most patients will fill this form out in our office and do not need to perform this step.)
Technical Note:
You will need Adobe Acrobat Reader to view our form. Please download the free Acrobat Reader from Adobe’s web site if it is not already installed on your system.