New Patient Forms & Documents

Offered at our convenient location in Lafayette, Louisiana

You may pre-register with our office by downloading and filling out the appropriate Patient Registration Packet. After you have completed the forms, please bring the packet on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it. Please feel free to call us with any questions.

Skin Care Patients

Skin Care Registration Form (111 KB)

Cosmetic Interest Questionnaire (83 KB)

Photo Consent Form (29 KB)

Notice of Privacy (HIPAA) (188 KB)

Receipt of Privacy Notice Receipt of Privacy Notice (70 KB)

General Forms

Drainage Instructions (120 KB)

Surgery Patients

Patient Registration Form (238 KB)

Confidential Health Questionnaire (232 KB)

Medical Records Release Form (47 KB)

Photo Consent Form (29 KB)

Financial Policy Form (78 KB)

Notice of Privacy (HIPAA) (188 KB)

Receipt of Privacy Notice (70 KB)