*Required fields are marked with an asterisk.

Patient Forms

In order to speed up your check-in wait time, please print and fill in these forms and bring with you to your next appointment.  You can also fill these forms in online and print.  If you are new to our clinic please fill out both forms.  If you are returning for a visit please fill out the Visit Intake Form.    

  Thanks NMC Front Desk     

      New Patient Registration   

Visit Intake Form 

Registration Requirements.

All patients are required to use a 1time/use unique Personal Identification Number (PIN) to verify their identify. You should have received this on the bottom of  your patient instructions at your office visit.  This PIN is only valid for 30 days and after you are registered you can discard it.  If you have trouble locating or using your PIN please call 225-761-2584 .  We can enroll you while you are on the phone.


Registration Process

Please note that you will need to complete all registration steps in order to start receiving secure messages from our office:

1:  Create a Login id.  (We recommend you use your email address) 
2:  Identity Verification to link your chart to your portal account 

Continue to registration.                

If you are ready to take advantage of our on-line services now  Register Today!