RESOURCES

The practice of Elizabeth B. White, M.D. is here to serve the medical needs of our patients.  In order to serve you better, you can access forms here to fill out and submit PRIOR to your appointment.  

MEDICAL HISTORY FORM - Pediatric Patients

MEDICAL HISTORY FORM - Adult Patients

NEW PATIENT FORM FOR ADULT AND PEDIATRIC PATIENTS

ACKNOWLEDGEMENT OF RECEIPT - Notice of Privacy Practices

AUTHORIZATION AND ASSIGMENT OF BENEFITS - for treatment and payment

NOTICE OF PRIVACY POLICIES
Dr. Elizabeth B. White, M.D.
COPYRIGHT 2013 ALL RIGHTS RESERVED ELIZABETH B. WHITE, M.D. 205 HIGHLAND PARK PLAZA, COVINGTON, LA 70433    985.871.8681
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INSURANCE PROVIDERS ACCEPTED
Aetna, Blue Cross/Blue Shield, Cigna, Coventry, Humana, Medicare, Wellcare, and United Health Care