Downloadable Forms

The Baton Rouge Clinic provides the following forms to save our patients time in the waiting area.

PATIENT REGISTRATION

For registration at The Baton Rouge Clinic, AMC

MEDICAL RECORDS

Release of Protected Health Information:

  For release of Medical Records  
  Phone: (225) 246-9770
  Fax:     (225) 246-9209






National Institute for Children's Health Quality (NICHQ) Forms for Pediatric Patients

These forms are part of a child's comprehensive assessment for ADD/ADHD.

MYCHART PROXY FORMS

Consent forms for proxy access:

DERMATOLOGY FORMS & INFORMATION

Instructions for before and after procedures and brochure overview.

MISCELLANEOUS FORMS

General forms as recommended by our doctors.

MRI FORMS

Questions, surveys and authorization forms.

APPLICATION FOR EMPLOYMENT

Paper application for employment