Patient Resources
Everything you need before, during, and after your visit — all in one place.
Patient Forms
Please review and complete the following forms before your appointment. Completing paperwork in advance helps us make the most of your visit.
New Patient Registration
Complete your demographic and contact information before your first visit.
Available at check-in or by request
Medical History Form
Provide your health history, current medications, allergies, and past diagnoses.
Available at check-in or by request
Insurance & Payment Authorization
Authorize billing and provide insurance information for your visit.
Available at check-in or by request
HIPAA Acknowledgment
Acknowledge receipt of our Notice of Privacy Practices.
Available at check-in or by request
To request forms in advance, call us at 501.232.9540.
Informed Consent for Wellness & Functional Health Services
Please read this entire form before your appointment. If you have questions or do not understand any part of this form, please ask a member of our healthcare team.
Notice of Privacy Practices
Our Notice of Privacy Practices explains how 1st Aid Medical may use and disclose your protected health information, your rights as a patient, and our legal responsibilities. You will be asked to acknowledge receipt of this notice at your first visit.
View Notice of Privacy PracticesPatient Portal
Our patient portal allows you to securely access your health records, review visit summaries, request prescription refills, and communicate with our team. Contact our office to get set up.
Contact Us to Get StartedFrequently Asked Questions
Prescription Refills
For prescription refill requests, please contact our office directly at 501.232.9540 during regular business hours. Please allow adequate time for your refill request to be reviewed. Refills for controlled substances and specialty medications may require an office visit.
Call 501.232.9540Medical Records Requests
To request a copy of your medical records, contact our office at 501.232.9540 or visit us in person. A signed authorization form is required. Processing times may vary. There may be a fee for copies of records as permitted by applicable law.
Call 501.232.9540If you are experiencing a medical emergency, call 911 or go to your nearest emergency room immediately. Do not use this website or contact forms for emergency medical situations.