SCHLAMP FAMILY MEDICAL CLINIC
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    • Dr. Kevin Schlamp
    • Emily Scuderi, N.P.
    • ​Maureen Poe, N.P.
    • Angie Ewalt, N.P.
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      • COVID Testing and Antibody Therapy
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Patient Resources

To better assist our patients reduce time spent in our office, we have supplied the most common forms that you must fill out prior to your first visit to our office. Please feel free to print the forms, fill them out to your best ability, and bring them in with you to your first appointment.

​New Patient Packet


Patient Registration
File Size: 14 kb
File Type: docx
Download File

Medical Questionnaire
File Size: 17 kb
File Type: docx
Download File

Financial Policy
File Size: 36 kb
File Type: docx
Download File

Notify of Privacy Practices
File Size: 12 kb
File Type: docx
Download File

HIPAA
File Size: 36 kb
File Type: docx
Download File

Controlled Substance Contract
File Size: 15 kb
File Type: docx
Download File

Telemedicine Consent
File Size: 19 kb
File Type: docx
Download File

General Explanation of Forms


Patient Registration
General information regarding the patient, emergency contact, insurance and guarantor. ​The guarantor is whoever holds the insurance policy. 
Medical Questionnaire
Information regarding patient medications, surgical history, vaccination history and allergies
Financial Policy
This policy addresses questions concerning your responsibility with fees or the payment process.
​Notify of Privacy Practices
You have received your HIPAA paperwork. 
​HIPAA 
Listing authorized person(s) to obtain medical information about yourself. Communication preferences.
Controlled Substance Contract
Guidelines for controlled substances
Telemedicine Consent
Patient consent for telemedicine appointments

   Payment Portal
$ Payment Portal
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APPOINTMENT REQUEST
Schedule Appointment
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                 Patient Portal
Patient Portal
 Our patient portal is available for all current patients.
 All you need to do is give the receptionist your email
address and ask them to create your patient portal/website.
They will give you a username, password, and instructions on how to proceed. 
This site will assist you with scheduling appointments,
​messaging your physician and requesting refills on medications. 
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Schlamp Family Medical Clinic

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Same Day Appointments & Walk-in's Welcome 

Hours of Operation

Monday - Wednesday 
​
8:00 AM - 7:00 PM
​Thursday 7:30AM-7PM
Friday 7:30AM-5:00PM

Address 

921 1st Avenue 
​Sulphur, LA 70663

Phone

(337) 527-6385 Office
(337) 527-3527 Fax
(337) 475-0056 Answering Service

(833) 682- 7682 Text
Website Design SLS Digital Consulting, LLC
  • Home
  • Our Medical Providers
    • Dr. Kevin Schlamp
    • Emily Scuderi, N.P.
    • ​Maureen Poe, N.P.
    • Angie Ewalt, N.P.
  • Medical Services
    • Services >
      • COVID Testing and Antibody Therapy
      • Home Visits
      • Chronic Care & Remote Monitoring
      • Telemedicine
      • Aesthetic Services >
        • BOTOX
        • JUVÉDERM
        • Lastisse
    • About Our Clinic
    • Patient Resources
    • FAQs
  • CareCredit
  • Contact
  • Surveys
  • Blog