ARcare

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Patient Forms

ARcare looks forward to having you join our family of satisfied patients. To schedule an appointment, please contact the ARcare location nearest you.

ARcare serves all of rural Arkansas with locations in Augusta, Bald Knob, Batesville, Batesville-Southside, Brinkley, Cabot, Carlisle, Cherry Valley, Conway, Cotton Plant, Des Arc, England, Hazen, Heber Springs, Horseshoe Bend, Jonesboro, Kensett, Lake City, Lonoke, McCrory, Mayflower, Melbourne, Newport, Parkin, Searcy, Swifton, and Wynne.

Once you have made your initial appointment, you can pre-register using the links below. To use our interactive forms, please complete the information and click submit. To use our downloadable forms, simply print and complete the forms prior to your arrival and bring them with you to your appointment. This will help to speed up the new patient registration process.

Register Online:

All information sent interactively is done so securely, protecting your privacy and adhering to all privacy laws.

Downloadable Forms:

  • Consent to Treatment
  • Notice of Privacy Practices
  • Payment Verification Form
  • Patient Rights and Responsibilities
  • HIPAA Privacy Form
  • New Patient Registration
  • Health History

Please note: It may take a few minutes to load the forms if you are using a slower Internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat free by clicking on the icon below.

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