Patient Forms
Thank you for selecting Louisiana Pain Care of Monroe and Ruston for your pain management care. To schedule an appointment, please call us at (318) 323-6405 or use our online appointment request form.
Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process.
Please be sure to bring forms with you to your first visit along with any diagnostic films or other test results that may have been ordered or performed by another physician.
Established patients can update forms online through our patient portal. If you need help accessing the portal, please call the office and we’ll be happy to help.
Downloadable Forms:
- New Patient Registration Packet
- Health History
- Pre-Procedure and Post-Procedure Instructions
- Nondiscrimination Notice (English)
- Nondiscrimination Notice (Vietnamese)
- Nondiscrimination Notice (Spanish)
- Physician Referral Document
Please note: It may take a few moments to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat Reader for free by clicking on the icon below.
