Patient Forms
Your time is just as valuable to us, as it is to you!!! In order to reduce time while checking in as a new patient, please print and fill out the following forms to bring with you for your first appointment. You will also need to provide your valid drivers license and insurance card(s).
Here is a new patient packet. Please print, fill out PRIOR to your appointment, and bring with you for the first appointment with Dr. Baquet! Included in this packet are detailed driving directions to our office!
Dr. Baquet New Patient Packet.docx
Microsoft Word document [273.6 KB]
Here is a new patient packet. Please print, fill out PRIOR to your appointment, and bring with you for the first appointment with Dr. Fontenot! Included in this packet are detailed driving directions to our office!
Dr. Fontenot New Patient Packet.docx
Microsoft Word document [266.6 KB]
Here is a new patient packet. Please print, fill out PRIOR to your appointment, and bring with you for the first appointment with Dr. Lipstate! Included in this packet are detailed driving directions to our office!
Dr. Lipstate New Patient Packet.docx
Microsoft Word document [259.0 KB]
Here is a new patient packet. Please print, fill out PRIOR to your appointment, and bring with you for the first appointment with Dr. Malin! Included in this packet are detailed driving directions to our office!
Dr. Malin's New Patient Packet.docx
Microsoft Word document [258.3 KB]
Here is a new patient packet. Please print, fill out PRIOR to your appointment, and bring with you for the first appointment with Dr. Rivers. Included in this packet are detailed driving directions to our office!
Dr Rivers' New Patient Packet.docx
Microsoft Word document [21.2 KB]
Don't forget to bring your insurance information with you
In order to register and treat you promptly, we request that our patients bring their current insurance information with them for every visit.
Here is an entire copy of our Notice of Privacy Practices form.
Notice of Privacy Practices Entire Form.[...]
Adobe Acrobat document [2.0 MB]
Important telephone numbers in case of emergencies:
| Organization | Telephone Number |
| Emergency Services & Fire Department | 911 |
| Centers for Disease Control and Prevention | 800-CDC-INFO (800-232-4636) |
The clinic will be closed 11/27/24 @ noon, 11/28/24 and 11/29/24 for Thanksgiving. We will reopen on 12/02/24 @ 8:00am.
We are located at
4212 W. Congress Street
Mailing - Suite 2300A
Physical - Suite 2300A and B
Lafayette, LA 70506
337-237-7801
Fax - Dr. Todd Baquet
337-233-2965
Suite 2300B
Fax - Dr. Justin Fontenot
337-233-5799
Suite 2300B
Fax -Dr. James Lipstate
337-235-1865
Suite 2300A
Fax - Dr. Jennifer Malin
337-235-1865
Suite 2300A
Fax - Dr. Laura Rivers
337-235-1865
Suite 2300A
Before your visit, make sure to download and print out our patient forms.
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