Patient Forms

Our patient forms are provided for you to print and complete before your scheduled visit to the office.  If you are scheduled as a new patient to see a provider other than Dr. LaCour, you will need to complete the NEW PATIENT FORMS and bring them in with you at the time of your appointment.  If you are scheduled as a new patient to see Dr. LaCour, please complete the NEW PATIENT FORMS - LACOUR and bring these with you at the time of your appointment. 

We will ask you at every visit to verify your current address and contact information, and we will ask to see your current insurance cards to make certain we have your information correct.  We do this to ensure that your insurance claim for services will not be rejected. 

Once a year we will ask you to fill out new REGISTRATION FORMS in order to keep your information current in our system. 

If you are scheduled for an annual visit, or if you have not been seen within the past year, we will ask you to print and complete the UPDATE YOUR INFORMATION forms below and bring them with you to your appointment. 

Thank you for your confidence in Dothan Medical Associates, P.C.

 

NEW PATIENT FORMS

NEW PATIENT FORMS – LACOUR

REGISTRATION FORMS

UPDATE YOUR INFORMATION