New Patient Information
Please fill out all paperwork and bring the following with you to your appointment:
New Patient Information
When calling to request a new appointment, you will be asked to provide certain personal, medical and insurance information required for scheduling a new patient visit. This information will be forwarded to the scheduling department and you will be contacted within 48 hours.
After your appointment is scheduled, please print and complete the attached forms prior to your appointment. This will help us keep the schedule on track for you and our other patients.Appointment Checklist for New Patients
Please arrive for your appointment 30 minutes before your scheduled appointment time and bring the following items:
-A valid picture ID such as a driver's license-Insurance cards
-Your payment for todays services
-current list of all medication/supplements you take
-Any pertinent medical records, including labs and x-rays -If you do not have your co-payment or do not have your insurance cards, you will be asked to reschedule your appointment.
Patient Forms
We have placed our new patient forms online for your convenience. We urge you to download them, fill them out, and bring them with you to your first appointment. This will assist us in serving you as efficiently as possible and help us to provide you with quality care.
To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.
- Assignment of Benefits - PDF Document- Patient Health History - PDF Document
- Designation of Personal Representative - PDF Document
- Welcome To Shreveport Internal Medicine - PDF Document
- Notice of Privacy Practices - PDF Document
- Privacy Acknowledgement - PDF Document
