Thank you for choosing Nouriche, the office of Dr. Kelly Cobb, for your health and wellness needs. To ensure that you receive the best care possible, please download, print and fill out the forms below. Thank you and we look forward to helping you reach all of your health and wellness goals.
I. New Patient Forms (Mandatory): Please submit completed forms prior to your appointment date and time. You may do so by faxing to (337) 266-4775, e-mailing to appointments@nourichemedspa.com, mailing to 605 Silverstone Rd, Ste 100, Lafayette, LA 70508 or arriving 30 minutes early for your appointment to allow time for processing.
• Patient Demographics/Registratioin, Assignment of Benefits, Living Will
• Authorization to Use/Disclose PHI, Medical Records Release
• Patient Portal Agreement, HIPAA Agreement
• Health History Profile
II. Office Policies and Procedures: Here at Nouriche we have policies and procedures in place to ensure the best experience possible with our office and staff. We are continually making progress and update this section periodically. Please review prior to your appointment and refer back to this information as needed.
• New Patient Appointment Expectations
• Return Appointment Expectations
• Annual/Well-check Appointments
• Insurance
• Medication Refill Policy
• Diagnostic Testing Results Policy
• No Show/Cancellation Policy
• Phone/Patient Portal Policy
• Patient Responsibilities
• Types of Appointments offered at Nouriche
