**DUE TO THE COVID-19 PANDEMIC, ALL PATIENTS ARE REQUIRED TO SUBMIT A PATIENT REGISTRATION FORM AHEAD OF THEIR APPOINTMENT. INCOMPLETE FORMS WILL DELAY YOUR CHECK IN PROCESS**
Please complete the information on your registration form below (grey boxes) and submit it online. If you are unable to submit this form online, you must call the office @ 337-625-2020 so that we can pre-register you over the phone.
All forms contain confidential information and are delivered to us through a secure Internet connection.