Patient Forms

Patients visiting Poole Dermatology, The Laser Center of New Orleans for the first time are required to complete certain forms prior to their scheduled appointment. These forms pertain to our office policies, insurance, and other procedures; as well as, patient information, medical history and how your medical records and other information will be handled (HIPAA). You can save time by completing these forms online (highlight/hypertext link) or printing out and bringing these completed forms to our office when you come to your appointment.

The forms below can be completed online and will be emailed to our front desk receptionist upon clicking the submit button at the bottom of each form.

You must fill out and submit all 6 forms in order for us to create and process your patient record:

Or you may download these forms in pdf format:

 Referral Source Sheet

 Patient Registration Form

 Patient Medical History

 Secured Credit Card Policy

 Understanding your Insurance and Claims Processing

 Gulf South Pharmacy Financial Disclosure

 Pre-Operative Surgical Instructions

Descarga En Español:

 Hoja de Referencia Fuente
 Formulario de Registro de Pacientes
 Historia de la Medicina

Book an Appointment

If you're a Cosmetic Patient, please call our office to schedule your appointment
(504) 838-8225

Poole Dermatology - Laser Center of New Orleans

111 Veterans Blvd. Ste 406
Metairie, LA 70005

Call us: (504) 838-8225

Hours of Operation

Monday: 8:00am - 4:30pm
Tuesday: 8:00am - 4:30pm
Wednesday: 8:00am - 4:30pm
Thursday: 8:00am - 5:30pm
Friday: 8:00am - 4:30pm
Saturday: Closed
Sunday: Closed

About Our Practice

At Poole Dermatology - Laser Center of New Orleans, our goal is to provide each one of our patients with high quality, personalized and compassionate care for all your dermatology needs. Our range of services include adult and pediatric general medical dermatology, surgical dermatology, skin cancer surgery and the latest advances in cosmetic and laser surgery...Read More & Meet Our Physicians

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We will not sell, nor authorize the sale of, any information we receive from you. Poole Dermatology website contains links to third-party websites. The purpose of this website is to provide general information and not medical advice. This website is not a substitute for consultation with a physician. Do not act or rely upon information from Poole Dermatology without seeking professional medical advice.