Patient Portal
Close

Call Now

  • Home
  • About Us
  • Services
    • Diabetes Management
    • Acute Illness and Injuries
    • Chronic Disease Management
    • Procedures and Minor Surgeries
    • Pediatric Wellness - KidMed
    • Medicare Wellness Visits
    • Diagnostic Testing
    • Onsite Laboratory
    • New Patients
    • Accepted Insurance
  • Patient Education
  • Forms
  • Contact Us

102 W. 112th Street

Cut Off, LA 70345

Call Us: (985) 632-5222

www.garybirdsallmd.com
Call Us: (985) 632-5222
Patient PortalPortal Icon
  • Home
  • About Us
  • Services

    • Diabetes Management
    • Acute Illness and Injuries
    • Chronic Disease Management
    • Procedures and Minor Surgeries
    • Pediatric Wellness - KidMed

    • Medicare Wellness Visits
    • Diagnostic Testing
    • Onsite Laboratory
    • New Patients
    • Accepted Insurance
    Patient Portal
  • Patient Education
  • Forms
  • Contact Us

Forms

Download patient form(s) by clicking the links below.

Advance Notice of Charges

Advance Notice of Charges

Consent to Treat

Consent to Treat

Flu Vaccine

Flu Vaccine

HIPPA

HIPPA

Medical Release

Medical Release

Patient Injection Log

Patient Injection Log

Pneumococcal Vaccine

Pneumococcal Vaccine

Registration Form

Registration Form

Workmans Comp

Workmans Comp

www.garybirdsallmd.com
  • Home
  • About Us
  • Patient Education
  • Forms
  • Contact Us

Back to top

www.garybirdsallmd.com

Copyright © 2023 Dr. Gary Birdsall Medical Clinic, LLC
All rights reserved.

IMPORTANT! All information presented in this website is intended for informational purposes only and not for the purpose of rendering medical advice. Statements made on this website have not been evaluated by the Food and Drug Administration. The information contained herein is not intended to diagnose, treat, cure or prevent any disease.

102 W. 112th Street,
Cut Off, LA 70345

Call Us: (985) 632-5222

Copyright © 2023 Dr. Gary Birdsall Medical Clinic, LLC
All rights reserved.

IMPORTANT! All information presented in this website is intended for informational purposes only and not for the purpose of rendering medical advice. Statements made on this website have not been evaluated by the Food and Drug Administration. The information contained herein is not intended to diagnose, treat, cure or prevent any disease.


WebToMed

Family Medicine Website Design by WebToMed