To speed processing and arrangements for consultation, please follow our 3 simple steps.
Adobe Acrobat is required to open the .pdf file.
Fill out our basic screening Medical History form.
> Download History form and fax
> Fill in digital form and email
Send us a copy of your Health Insurance card and completed
Medical History form*
> by email to Liz@breastcenter.com
> send by fax 504-899-2700
> send by postal mail:
1717 St. Charles Avenue
New Orleans, LA 70130
* please send your medical records with the form, including
copies of the back and front of your insurance card. All info
has to be received in order to process and schedule a date
for a consult or surgery.
Confirm we have your information and schedule time to speak to educator
> please call the Center at 888-899-2288 to confirm that your form and insurance card was received.