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Patient Services: Patient Registration

You have three (3) options for registering for your surgery:

  1. Complete the Pre-Admission Form below and email it to us.
  2. Complete the Pre-Admission Form below and Fax it to us at 225-763-6163.
  3. Complete the Pre-Admission Form below and deliver it to the Surgery Center.

Click on the Pre-Admission Form link below; that will open a PDF file you can complete on your computer. (This document requires that you have Adobe Reader. If you don't have Adobe Reader, click here for a free download.)

Pre-Admission Form

Once you have completed the Pre-Admission Form, you will need to print or save it to your computer, then submit in the method most convenient for you:

  1. Email to in one of two ways:
    a. Send an email with your completed form as a file attachment.
    b. Submit your saved form using the quick form below.

    Click "Browse," and select the completed form you saved to your computer:
    Then click "Submit," to send us the form.

  2. Fax to 225-763-6163
  3. Deliver to:
    7301 Hennessy Blvd. Suite 100
    Baton Rouge, LA 70808

Don't hesitate to call us if you have questions at 225-763-6011. Our staff is ready to assist you and will maintain your confidentiality.