How to Refer Patients

To schedule an appointment for your patient with Dr. Almubaslat, please call the

scheduling line at: (985) 400-3210

OR fax the face sheet or referral form to (855) 553-6931


Download the Referral Form here:




The Referral form is only for your convenience and is not required to be filled prior to scheduling a referred patient.  We always maintain an easy process for all other physicians in order to accommodate patients as fast as possible.  Please fax us any pertinent records for the referred patient at the time of referral.

Your Name (required)

Your Email (required)

Your Phone Number (required)

Insurance or Financial Provider

Best Time To Call You

Appointment Time Preference

Message Subject

Your Message