How to Become a Patient

• You will need a signed referral from a physician, NP, PA, podiatrist, or chiropractor for therapy.
• A referral can be brought in to the clinic, faxed to (318) 442-0562, or scanned and emailed to us at therapyinfo@midstateortho.com.
• If you need one of our referral forms, click on the link in Form Downloads box and this can be signed by your provider.
• Our office can accept therapy referral even if they are not on our letterhead.
• Once our office receives a copy of your referral, we can schedule your first therapy appointment.

Form Downloads