Patient Forms

Contact Us!

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Office location:
Lake Charles
4001 Louisiana Ave
Lake Charles, LA
Phone: 337-245-2018

The first visit to our office is designed to get you better acquainted with all we offer as well as introduce you to Dr. Chaumont and our caring staff. We encourage questions and do our best to always deliver quality care.

Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to assisting you with all your dental needs.


New Patient Forms Bundle

Dental Discount Plan pg1

Dental Discount Plan pg2

HIPPA (Read Only)


Consent & Pre-Post for Oral Conscious Sedation

Consent for Oral Surgery / Extraction(s)

Consent for Endodontics (Root Canal Therapy)

Consent for Teeth Whitening

Consent for Denture(s)

Consent for Flipper(s)

Consent for Removable Partial Denture(s)


Post-op extractions

Post-op scaling & root planning

Teeth Whitening




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