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

HIPAA Records Release

New Patients

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

Patient Information

HIPAA Notice of Privacy Practices

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