Patient Info

Patient Forms

Click on the links below to open our new patient forms. You can also right click and “Save As” to download them to your computer.

Patient Registration Form (PDF)

Medical History Form (PDF)

HIPPA Notice (PDF)

Financing Options

Since our office provides the highest quality dental care available, we are not a participating provider for Medicaid. Please contact us at 501-843-9561 with any questions regarding billing or insurance.

We accept cash, credit, and financing from the following:

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