New Patients & Online Forms

These tips will help you obtain the maximum benefit from your visit with us:

You will be asked to fill out a new patient registration form. To save time you can print one here and bring it with you already completed.
 
You should bring any test results or films (such a mammograms) with you. These can be obtained by contacting the facility where they were performed and requesting to pick them up.
 
Request that any reports from your tests be mailed or faxed to us. Our fax number is (318) 524-9569.
 
Bring your insurance card. We will need to make a copy for your medical records.

Print Forms

Download and print our registration forms, fill them out and fax them in or bring it with you for your first appointment.

These forms require Adobe Reader to view. Click here to download it free.

Registration Form
This is your personal and family contact information.

New Patient History Form
This is your medical history.  Please fill it out carefully

Alternate Contact Form
This form names the specific individuals that we may speak with about your appointments, care and other information in the event we cannot contact you.

Care Consent
This form gives permission for the doctors to treat you.

HIPPA Form
This form describes how your medical information is used by the doctors.

Medicare/Medigap
Form for Medicare patients with Medigap coverage.