New Patient Form – click the “NEW PATIENT PAGE” and it will bring you to the New Patient Form. **Please be sure to fill out all tabs: Demographics, Primary Insurance, Secondary Insurance, Vision Insurance, and Medical History before you select the SUBMIT DATA button at the end of the form.
Existing Patient Form – you WILL need a PASS CODE to complete this form. Please call us at (318)323-4994 to get your pass code. **Please be sure to UPDATE all tabs: Demographics, Primary Insurance, Secondary Insurance, Vision Insurance, and Medical History before you select the SUBMIT DATA button at the end of the form.