337.981.2393 [email protected]

Patient Information

Fill out your Patient Forms prior to your visit by printing them out here. Click on the link, open the file and print. Please allow 2 to 4 minutes for each form to print.
Forms in Adobe (PDF) Format

LASIK Screening History

Download Form

HIPAA Records Release

Download Form

New Patients

Please download, print and fill out the following four forms:

Patient Information

Download Form

HIPAA Notice of Privacy Practices

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Location
203 Rue Louis XIV, Suite A
Lafayette, LA 70508

Hours
Monday -  Thursday 8:00 am to 5:00 pm
Friday 8:00 am to 12:00 pm

Contact Us
P: (337) 981-2393
F: (337) 981-9470

Leoni Eye Clinic

203 Rue Louis XIV, Suite A
Lafayette, LA 70508
P: (337) 981-2393
F: (337) 981-9470