• preventative
• cosmetic
• restorative
• examples

• what they say

• an appointment
• office tour

• about Dr. Pousson
• about our staff
• what to expect
• contact
• directions
• new patient forms

New patient forms

Thank you for choosing Pousson Family Dentistry! For your convenience, please download and complete the following new patient forms. You may bring them with you to your first appointment or fax them to (985) 643-2824.

All files are in PDF format and require Adobe Acrobat Reader. If you are unable to open the file, please visit the official Adobe Acrobat Reader download site.

New Patients (under 18)

• New Patient
• Consent for Dental Procedure
• Child Medicaid

New Patients (18 and over)

• New Patient
• Consent for Dental Procedure
• Adult Medicaid

New Patients (no insurance)

• New Patient
• Financial Consent

New Patients (with insurance)

• New Patient
• Financial Consent
• Insurance Consent

All patients

• Notice of Privacy Practices (HIPPA)