For faster check-in, please print, fill out and bring to clinic. You must also provide drivers license and government-issued ID.
*Established Patients: Please call our clinic as we now can eRegister you over the phone. e-Registered patients have a faster, paperless visit! Call today!
- COVID 19 Patient Check-In Paperwork
- New Patient Check-In Paperwork*
- Non-Coverage Consent (*required for Medicaid plans)
- Authorization to Release Healthcare Information Form
- Minor Form
- Flu Shot Questionaire
- TB Skin Test
- Hepatitis B Vaccination
- Pneumonia Vaccination
Please call us if you have any questions. Visit our Contact Us page for location information.
LaPlace (985) 359-2273 Westbank (504) 393-2273
148 Wall Boulevard
Gretna, LA 70056
1706 Cannes Drive
LaPlace, LA 70068
231 N Carrollton Avenue
New Orleans, LA 70119
4517 Veterans Blvd
Metairie, LA 70006