Online Appointment Request

If you would like to request an appointment, please feel free to call our office or fill out the online appointment request below. If your request for an appointment comes in over the weekend, we will return your call on Monday. It is important to note that this is a request for an appointment. Our Scheduling Coordinator will call you back to set up your appointment, discuss possible appointment times and details about what you need to bring to the appointment. If you are requesting same day appointment, please call the office at (337) 474-2233, to check for same day availability. Please note that same day appointments are not always available due to high patient volume.

Online Appointment Request Form

    *- Required Fields

    Full Name (Last, First, Initial)*

    Phone Number*

    Email Address*

    Home Address*

    Preferred Date of your Appointment*

    Preferred Time of your Appointment*

    Reason for Appointment Request?*

    Insurance Carrier

    How did you hear about us?*
    Social Media/InternetFriend or FamilyReferralNewspaper/TV/RadioOther

    Main Office

    212 W. McNeese Street Lake Charles, LA 70605
    Phone: (337) 474-2233
    Fax: (337) 478-1994
    Map and Directions

    Business Hours

    Monday: 
    Tuesday: 
    Wednesday:
    Thursday:
    Friday:
    8:00am - 5:00pm
    8:00am - 5:00pm
    8:00am - 5:00pm
    8:00am - 5:00pm
    8:00am - 12:00pm