New Patient Forms

We know that your time is very valuable; therefore to save you time we have placed the new patient form on our website. You can download the form, fill it out, and then bring it to your first visit, or fax it to our office at 337-984-9808.

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John C. Theriot DDS, Kayla Soirez DDS and Associates
Jtheriot25@hotmail.com

121 Rue Louis XIV, Suite 2
Lafayette, LA 70508
Phone - 337-984-3408
Fax - 337-984-9898

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care credit