Patient Resources

Downloadable Forms:

Patient Registration and Authorization Form

Family History Form

Statement of Financial Responsibility

Age group:

We here at Acadiana Pediatric Gastroenterology and Hepatology Associates see patients ranging in age from birth to 22 years. Premature infants with any type of gastrointestinal issues are also welcome.

Prepare for your Office Visit

In addition to completing the above forms, we will require the following information for your first visit:

Driver's License or Other Valid Government-Issued Photo Identification.
Insurance card. 
Referral or consultation form, if applicable.
Prior X-Rays, MRI Films, CT Scans, Endoscopy Reports, etc.
Any pertinent medical history, such as lab results.
Co-payment due for visit.
Minors must be accompanied by a parent or guardian.
Please bring all prescription medications, including empty bottles with you on the day of your visit.

It is very important to have these available at the time of visit to enable the doctor to make a full assessment.

We Look Forward to Seeing You!

Please arrive at least 30 minutes early if you have not yet filled out these forms. 

Thank you for your assistance completing this information. We look forward to seeing you on the day of your appointment!

Renew a Rx

Prescription renewals are handled Monday through Friday, 8 AM - 4 PM. No prescription will be filled after 4 PM.

If your prescription is running low, please do not wait until the weekend or until your medication has totally run out. If you plan to travel out of town, please make sure that you have a sufficient supply of medicaton for your trip.

To renew a prescription, please call the main office number. We will handle your request as soon as possible.

Billing and Payments

We accept payment by cash, check, or credit card.
To pay by check, please mail to our main office address, and notify us of the same.
To pay by credit card, please call us. We accept Visa, Mastercard and American Express.