Jefferson Ambulatory Surgery Center
2701 Lake Villa Drive • Suite B • Metairie, Louisiana 70002
phone: (504) 274-3100 • fax: (504) 274-3199
get driving directions

Forms/Instructions

Pre-Operative testing and registration must be completed at least 2-3 days prior to your surgery. An appointment is required for pre-operative testing, which can be scheduled
Monday-Friday, between 7:30am-12:30pm.


Medical Forms

For your convenience, our medical forms are provided below. Please complete, sign, and bring the forms found in the links below as they pertain to the reason for your visit on the day of your pre-op appointment or for your pain management procedure.

We also request that you bring in your insurance card (not needed if through worker’s compensation) and a valid ID (driver’s license or state issued ID) with you to your pre-op appointment or for your pain management procedure.

Pre-Op/Surgery

Please visit Your Day of Surgery for more information pertaining to your pre-operative testing appointment

Pain Management