7053 Johnston St, Lafayette, La 70503
Information for New Patients
Preparing For Your First Appointment
When you come for your first appointment, please bring the following:
Your insurance card
Your driver's license or state ID
A list of your current medications
Your contact information (telephone, email address, and mailing address)
Details of your medical history
List of providers seen in the last 5 years
To help us provide you the best care we ask all new patients to print, complete, and sign this form and return before your first visit. If you are not able to print, please call us at 337-408-3375 and we will mail you the forms.
All new patients are asked to complete this form and bring it to your first visit. Established patients are asked to update this form and sign it annually.
All new patients are asked to complete this form and return it to us before your visit or bring it to your first visit.
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