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Patient Forms

The following patient forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save time during your visit.

  • Patient Registration Form
  • Authorization to Release Healthcare Information
  • HIPPA Notice of Privacy Practices

 

Note: To view or print these forms, you will need Adobe Acrobat Reader.

Click here to download it.

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Contact Our Office

  • 16777 Medical Center Drive
    Baton Rouge, LA 70816
  • Ph: 225-754-3278

Starting March 2020, I am now an Ochsner provider seeing patients at the same location as above. Please, call 225-754-3278 if you have any questions or to schedule an appointment. Thank you.

Online Payment Portal

For your convenience, we offer a secure way for patients to pay their bill online.

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