New Patient Forms



Click Below to Fill out our new patient forms.

Very Important: Once Completed, right click "save as" or "print".


You may either bring these forms in with you for your appointment, or email them to us at: This email address is being protected from spambots. You need JavaScript enabled to view it. 


In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.

Hours of Operation

Monday 08:30 - 12:00/1:30 - 5pm
Tuesday 08:30 - 12:00/1:30 - 5pm
Wednesday 08:30 - 12:00/1:30 - 5pm
Thursday 08:30 - 3pm
Saturday CLOSED

Leonard J. Pizzolatto III, D.D.S

875 Verret St. Houma, LA 70360
Phone: (985) 851-4633