Before You Arrive

 

General Information:

 

When you visit BRPCC, please be prepared to provide the following information:

 

 

  • Whether you have been a patient before

 

  • Social security number

 

  • Date of birth

 

  • Address 

 

  • Telephone number (home and cell phone) 

 

  • E-mail address

 

  • Picture ID

 

  • Current insurance card and Patient and policy holder name,

 

  • Co-payment or deductible amount, if applicable, which will be due at the time of service

 

  • Your primary care physician's name

 

  • List of your current medications

 

Click on the forms below.  You may print and complete the forms and bring them with you on your visit. ​This information is needed to expedite your registration and to assist us in understanding the urgency of your visit. Thank you for choosing Baton Rouge Primary Care Collaborative for your healthcare needs.