5421-H Lapalco Blvd,
Marrero, LA 70072
5421-H Lapalco Blvd.
Marrero, LA 70072
CALL US! (504) 264-6461 Rate Us

New Patient Form

Thank you for choosing Lapalco Family Dental! We provide cutting edge treatments and quality patient care. We work continuously to deliver comfortable treatments and wonderful treatment results.

To help patients have a stress-free visit, we have made patient forms available for download on this page. This small step gives you the option fill out the forms at your own pace.

Please take a minute to print and fill out the patient forms. Kindly bring them to your appointment along with:

  • Dental X-rays taken in the past 6 months, if any
  • Information on the medication you may be currently taking


The information collected will help the doctor select the most effective method of treatment for you. If you have questions, concerns or need help with the forms, please don’t hesitate to dial 504-264-6461 or use the online form. We are here to help.

Pt Registration Form – Download

Medical History Form – Download

Make An Appointment

Need a SMILE MAKEOVER, full mouth reconstruction or cosmetic procedure like veneers or crowns? Set up an appointment now without picking up the phone.

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