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Admission Assessment Form

Thank you for choosing Surgicare of Lake Charles. Prior to your surgery, please download our Admission Assessment Form, fill it out, and either fax, email or return it to us prior to your surgery.

FAX: 337-377-0414


2100 Lake Street Lake Charles, LA 70601

Before Surgery
Day of Surgery
After Surgery
Patient Handout Adult
Pediatric Rights and Responsibilities‚Äč
Good Faith Estimate for Health Care Services

Leave Your Phone Number, A Member Of Our Team Will Be In Touch.

Should you have any questions regarding an upcoming procedure, please contact your physician’s office, or leave your contact information here and someone will get back with you.
Surgicare of Lake Charles