Patient Forms

Welcome to Lake District Family Dentistry!

To better serve our new patients, we ask that you complete the New Patient form before your first visit.

NEW PATIENTS CLICK HERE >>>>>>>>>> NEW PATIENT PORTAL <<<<<<<<<<<<< NEW PATIENTS CLICK HERE


IN ORDER TO SECURE YOUR SCHEDULED APPOINTMENT, NEW PATIENT INFORMATION SHOULD BE FILLED OUT
24 HOURS BEFORE YOUR DENTAL APPOINTMENT.


PATIENTS WITH INSURANCE– IF we will be filing insurance on your behalf we will need the necessary information BEFORE your dental
visit. The process of insurance verification can be lengthy! Our office prefers to have this completed and ready when you arrive for your dental appointment. This information can be sent in two ways, by text or by email.


********Use your phone to take a photo of the front and back of the card.

SEND INSURANCE CARD BY TEXT TO: 318-445-4870 or SEND INSURANCE CARD BY EMAIL TO: frontdesk@lakes-dental.com

  • OTHER FORMS

  • Epworth Sleepiness Scale – Patients interested in a sleep appliance
  • Records Request – Fill out and fax or email if you are new to practice and have dental records we need to request from your previous provider. (Only photos and xrays within the past two years will be helpful to future treatment)
  • Release Records – Fill out and fax or email if you are transferring out or moving away