Online Forms - Lafayette Internal Medicine Clinic | Best Internal Medicine Doctors Lafayette Louisiana
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Online Forms

Online Forms

Lafayette Internal Medicine Specialists

Downloadable Forms

Adobe® Acrobat® Reader® is required to view the following forms.
To download this free software click here.

New Patient Forms

To help reduce your waiting time, you can print and complete the below forms prior to your office visit. Please bring them with you, rather than mailing or faxing them to us. Please complete ALL forms.

1. Patient Registration
2. Health History
3. Medication List (*please bring medications with you to your appointment*)
4. HIPAA Consent
5. Patient Policy
6. Financial Policy
7. Receipt of Policies
8. Patient Portal Consent Agreement
9. Medical Records Release

If you need any assistance with these forms please feel free to call (337)504-3335.

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